Search results for: successful treatment

Authors: Yenesew Mengiste Yihun, Abraham Mehari Haile, Teklu Erkossa, Bart Schultz

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Teff (Eragrostic tef) is a staple food in Ethiopia. The local and international demand for the crop is ever increasing pushing the current price five times compared with that in 2006. To meet this escalating demand increasing production including using irrigation is imperative. Optimum application of irrigation water, especially in semi-arid areas is profoundly important. AquaCrop model application in irrigation water scheduling and simulation of water productivity helps both irrigation planners and agricultural water managers. This paper presents simulation and evaluation of AquaCrop model in optimizing the yield and biomass response to variation in timing and rate of irrigation water application. Canopy expansion, canopy senescence and harvest index are the key physiological processes sensitive to water stress. For full irrigation water application treatment there was a strong relationship between the measured and simulated canopy and biomass with r2 and d values of 0.87 and 0.96 for canopy and 0.97 and 0.74 for biomass, respectively. However, the model under estimated the simulated yield and biomass for higher water stress level. For treatment receiving full irrigation the harvest index value obtained were 29%. The harvest index value shows generally a decreasing trend under water stress condition. AquaCrop model calibration and validation using the dry season field experiments of 2010/2011 and 2011/2012 shows that AquaCrop adequately simulated the yield response to different irrigation water scenarios. We conclude that the AquaCrop model can be used in irrigation water scheduling and optimizing water productivity of Teff grown under water scarce semi-arid conditions.

Keywords: AquaCrop, climate smart agriculture, simulation, teff, water security, water stress regions

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Authors: Isaac Kofi Mensah, Mi Jianing

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The lack of Information and Communication Technologies (ICT) infrastructure in African countries is hampering the successful adoption, development and implementation of e-government in Africa. Electronic government is the use of ICTs to modernize government public administration processes and to provide government services to citizens with a purpose to enhance efficiency, accountability, and transparency in government’s interaction with the citizenry. ICT application in public administration has the potential to modernize and create smarter government and improvement in public service delivery. China’s Internet Plus policy and One Belt One Road strategy present a golden opportunity for countries in Africa to attract the huge financial investment through Chinese IT companies to develop and close Africa’s ICT infrastructure gap. This study recommends the establishment of One Belt One Road ICT Infrastructure Fund for Africa (OBOR ICT Fund for Africa) to enable countries in Africa to source solely for the purpose of ICT infrastructure development in the public sector/government machinery which would in turn promote the adoption and development of e-government in the public sectors of respective countries in Africa.

Keywords: e-government, public service delivery, internet plus, one belt one road initiative, China, Africa

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Authors: S. Gordon

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Dual language immersion is growing fast in language teaching today. This study provides an overview and evaluation of the different models of Dual language immersion programs in US K-12 schools. First, the paper provides a brief current literature review on the theory of Dual Language Immersion (DLI) in Second Language Acquisition (SLA) studies. Second, examples of several types of DLI language teaching models in US K-12 public schools are presented (including 50/50 models, 90/10 models, etc.). Third, we focus on the unique example of DLI education in the state of Utah, a successful, growing program in K-12 schools that includes: French, Chinese, Spanish, and Portuguese. The project investigates the theory and practice particularly of the case of public elementary and secondary school children that study half their school day in the L1 and the other half in the chosen L2, from kindergarten (age 5-6) through high school (age 17-18). Finally, the project takes the observations of Utah French DLI elementary through secondary programs as a case study. To conclude, we look at the principal challenges, pedagogical objectives and outcomes, and important implications for other US states and other countries (such as France currently) that are in the process of developing similar language learning programs.

Keywords: dual language immersion, second language acquisition, language teaching, pedagogy, teaching, French

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Authors: Albert Bou, Sebastian Dittert, Gianni de Fabritiis

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Advancing reinforcement learning (RL) requires tools that are flexible enough to easily prototype new methods while avoiding impractically slow experimental turnaround times. To match the first requirement, the most popular RL libraries advocate for highly modular agent composability, which facilitates experimentation and development. To solve challenging environments within reasonable time frames, scaling RL to large sampling and computing resources has proved a successful strategy. However, this capability has been so far difficult to combine with modularity. In this work, we explore design choices to allow agent composability both at a local and distributed level of execution. We propose a versatile approach that allows the definition of RL agents at different scales through independent, reusable components. We demonstrate experimentally that our design choices allow us to reproduce classical benchmarks, explore multiple distributed architectures, and solve novel and complex environments while giving full control to the user in the agent definition and training scheme definition. We believe this work can provide useful insights to the next generation of RL libraries.

Keywords: deep reinforcement learning, Python, PyTorch, distributed training, modularity, library

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Authors: Muhammad Bilal, Adil Ahmed

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This study proposes an approach for electrical induction motor predictive maintenance utilizing machine learning algorithms. On the basis of a study of temperature data obtained from sensors put on the motor, the goal is to predict motor failures. The proposed models are trained to identify whether a motor is defective or not by utilizing machine learning algorithms like Support Vector Machines (SVM) and K-Nearest Neighbors (KNN). According to a thorough study of the literature, earlier research has used motor current signature analysis (MCSA) and vibration data to forecast motor failures. The temperature signal methodology, which has clear advantages over the conventional MCSA and vibration analysis methods in terms of cost-effectiveness, is the main subject of this research. The acquired results emphasize the applicability and effectiveness of the temperature-based predictive maintenance strategy by demonstrating the successful categorization of defective motors using the suggested machine learning models.

Keywords: predictive maintenance, electrical induction motors, machine learning, temperature signal methodology, motor failures

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Authors: Caroline Demartin, Natalia Camaras, Nelson Maestrelli, Max Filipe Gonçalves

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This paper presents a case study of Lean Thinking at the cargo transport area. Lean Office principles are considered the application of Lean Thinking focusing on the service area and it is based on Lean Production concepts. Lean production is a philosophy that was born and gained ground after the Second World War when the Japanese Toyota Company developed a process of identifying and eliminating waste. Many researchers show that most part of the companies decide to adopt the principles created at Toyota especially in the manufacturing sector, but until 90’s, has no major applications for the service sector. Due to increased competition and the need for competitive advantage, many companies began to observe the lean transformation and take it as reference. In this study, a key process at a cargo transport company was analyzed using Lean Office tools and methods: a current state map was developed, main wastes were identified, some metrics were used to evaluate improvements and a priority matrix was used to identify action plans. The obtained results showed that Lean Office has a great potential to be successful applied in cargo air transport companies.

Keywords: lean production, lean office, logistic, service sector

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Authors: Mariem Meddeb Sidhom, Souhayel Hedfi, Rjaibia Houda, Mehdi Dridi, Mohamed Ali Yousfi, Sâadia Gargouri

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Considering the important increase in costs of caspofungin treatments and ahead the evolution of its indication, pharmacy department was prompted to realize a review of the adequacy of prescriptions in the medical intensive care units (ICU). A retrospective observational study was conducted in Tunis military hospital concerning ICU prescriptions of caspofungin from 2008 until 2013. A pharmacist had returned to the patient’s medical records to collect data and to the microbiology department for parasitological results. The adequacy of prescriptions was evaluated by a pharmacist and an infectiologist parasitologist, referring to predefined scale of criteria resuming the indications of the marketing authorization (MA) and grade AI-AII of the guidelines of the Infectious Diseases Society of America (IDSA). Sixty two ICU patients have been treated with caspofungin during the period of study; however, 8 files were lost. Thus, 54 patients were included in the study having received 55 prescriptions of caspofungin. Males were a majority with 64.8% of the population. Mean age was 51 years. Caspofungin was indicated in accordance with the IDSA recommendations in 43.6% of the cases. The most case of non respect to the guidelines was the indication of caspofungin as empirical treatment in non neutropenic patients. Caspofungin was utilized as a first line treatment in 9 cases where it was possible to give fluconazole first, as germs were fluconazole- sensitive. Caspofungin was indicated in 2 patients with good renal function and in which nor amphotericin B, liposomal ampho B neither itraconazole had been previously used, as indicates the MA. The posology of caspofungin was respected in all prescriptions with a loading dose of 70 mg in the first day and a maintenance dose of 50 mg daily. Seven patients had received a daily dose of 70 mg, the recommended dose for people weighing more than 80 Kg. Caspofungin prescriptions are far to be adequately done. There is a clear need of optimization in indicating this molecule and that must be done in collaboration between the pharmacy department, the ICUs and parasitology department.

Keywords: caspofungin, prescription, intensive care units, marketing authorization, Tunisian hospital cohort

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Authors: Danika Tynes

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Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory (Rogers, 1962). System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of telehealth (teleradiology, teledermatology, telepathology, telepsychology, and remote monitoring) using multiple logistic regression. The analyses supported relative advantage and compatibility as the strongest influencers of telehealth adoption, remote monitoring in particular. These findings help to quantitatively clarify the factors influencing the adoption of innovation and advance the ability to make recommendations on the viability of state telehealth adoption. In addition, results indicate when DoI theory is most applicable to the understanding of telehealth diffusion. Ultimately, this research may contribute to more focused allocation of scarce health care resources through consideration of existing state conditions available foster innovation.

Keywords: adoption, diffusion of innovation theory, remote monitoring, system-level indicators

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Authors: Oleg Sapelnikov, Ruslan Latypov, Darina Ardus, Samvel Aivazian, Andrey Shiryaev, Renat Akchurin

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OBJECTIVE: MAZE procedure is one of the most effective surgical methods in atrial fibrillation (AF) treatment. Nowadays we are all aware of its modifications. In our study we conducted clinical analysis of “Box lesion+” approach during MAZE procedure in two-year follow-up. METHODS: We studied the results of the open-heart on-pump procedures performed in our hospital from 2017 to 2018 years. Thirty-two (32) patients with atrial fibrillation (AF) were included in this study. Fifteen (15) patients had concomitant coronary bypass grafting and seventeen (17) patients had mitral valve repair. Mean age was 62.3±8.7 years; prevalence of men was admitted (56.1%). Mean duration of AF was 4.75±5.44 and 7.07±8.14 years. In all cases, we performed endocardial Cryo-MAZE procedure with one-time myocardium revascularization or mitral-valve surgery. All patients of this study underwent pulmonary vein (PV) isolation and ablation of mitral isthmus with additional isolation of LA posterior wall (Box-lesion+ procedure). Mean follow-up was 2 years. RESULTS: All cases were performed without any complications. Additional isolation of posterior wall did not prolong the operative time and artificial circulation significantly. Cryo-MAZE procedure directly lasted 20±2.1 min, the whole operation time was 192±24 min and artificial circulation time was 103±12 min. According to design of the study, we performed clinical investigation of the patients in 12 months and in 2 years from the initial procedure. In 12 months, the number of AF free patients 81.8% and 75.8% in two years of follow-up. CONCLUSIONS: Isolation of the left atrial posterior wall and perimitral area may considerably improve the efficacy of surgical treatment, which was demonstrated in significant decrease of AF recurrences during the whole period of follow-up.

Keywords: atrial fibrillation, cryoablation, left atrium isolation, open heart procedure

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Authors: A. Ghribi, M. Bagane

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The discharge of dye in industrial effluents is of great concern because their presence and accumulation have a toxic or carcinogenic effect on living species. The removal of such compounds at such low levels is a difficult problem. The adsorption process is an effective and attractive proposition for the treatment of dye contaminated wastewater. Activated carbon adsorption in fixed beds is a very common technology in the treatment of water and especially in processes of decolouration. However, it is expensive and the powdered one is difficult to be separated from aquatic system when it becomes exhausted or the effluent reaches the maximum allowable discharge level. The regeneration of exhausted activated carbon by chemical and thermal procedure is also expensive and results in loss of the sorbent. The focus of this research was to evaluate the adsorption potential of the raw clay in removing rhodamine B from aqueous solutions using a laboratory fixed-bed column. The continuous sorption process was conducted in this study in order to simulate industrial conditions. The effect of process parameters, such as inlet flow rate, adsorbent bed height, and initial adsorbate concentration on the shape of breakthrough curves was investigated. A glass column with an internal diameter of 1.5 cm and height of 30 cm was used as a fixed-bed column. The pH of feed solution was set at 8.5. Experiments were carried out at different bed heights (5 - 20 cm), influent flow rates (1.6- 8 mL/min) and influent rhodamine B concentrations (20 - 80 mg/L). The obtained results showed that the adsorption capacity increases with the bed depth and the initial concentration and it decreases at higher flow rate. The column regeneration was possible for four adsorption–desorption cycles. The clay column study states the value of the excellent adsorption capacity for the removal of rhodamine B from aqueous solution. Uptake of rhodamine B through a fixed-bed column was dependent on the bed depth, influent rhodamine B concentration, and flow rate.

Keywords: adsorption, breakthrough curve, clay, fixed bed column, rhodamine b, regeneration

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Authors: A. Abdulkadir, Y. M. Bello, A. A. Okhimamhe, H. Ibrahim, M. B. Matazu, L. S. Barau

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The increasing volume of solid waste generated, collected and disposed daily complicate adequate management of solid waste by the relevant agency like Niger State Environmental Protection Agency (NISEPA). In addition, the impacts of solid waste on the natural environment and human livelihood require identification of cost-effective ways for sustainable municipal waste management in Nigeria. These signal the need for identifying environment-friendly initiative and local solution to address municipal solid waste. A research field was secured at Pago, Minna, Niger State which is located in the guinea savanna belt of Nigeria, within longitude 60 3614311- 4511 and latitude 90 291 37.6111- .6211 N. Poultry droppings, decomposed household waste manure and NPK treatment were used. The experimental field was divided into three replications and four (4) treatments on each replication making a total of twelve (12) plots. The treatments were allotted using Randomized Complete Block Design (RCBD) and Data collected was analyzed using SPSS software and RCBD. The result depicts variation in plant height and number of leaves at 50% flowering; Poultry dropping records the highest height as a number of leaves for waste manure competes fairly well with NPK treatment. Similarly, the varying treatments significantly increase vegetable yield, as the control (Nontreatment) records the least yield for the three vegetable samples. Adoption of this organic manure for cultivation does not only enhance environment quality and attainment of food security but will contribute to local economic development, poverty alleviation, and social inclusion.

Keywords: environmental issues, food security, NISEPA, solid waste

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Authors: Pham Minh Duc, Tran Thi Thanh Hien, David A. Bengtson

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Laboratory feeding trial: the study was conducted to find out the optimal dietary vitamin C, or ascorbic acid (AA) levels in terms of the growth performance of snakehead. The growth trial included six treatments with five replications. Each treatment contained 0, 125, 250, 500, 1000 and 2000 mg AA equivalent kg⁻¹ diet which included six iso-nitrogenous (45% protein), iso-lipid (9% lipid) and isocaloric (4.2 Kcal.g¹). Eighty snakehead fingerlings (6.24 ± 0.17 g.fish¹) were assigned randomly in 0.5 m³ composite tanks. Fish were fed twice daily on demand for 8 weeks. The result showed that growth rates increased, protein efficiency ratio increased and the feed conversion ratio decreased in treatments with AA supplementation compared with control treatment. The survival rate of fish tends to increase with increase AA level. The number of RBCs, lysozyme in treatments with AA supplementation tended to rise significantly proportional to the concentration of AA. The number of WBCs of snakehead in treatments with AA supplementation was higher 2.1-3.6 times. In general, supplementation of AA in the diets for snakehead improved growth rate, feed efficiency and immune response. Hapa on-farm trial: based on the results of the laboratory feeding trial, the effects of AA on snakehead in hapas to simulate farm conditions, was tested using the following treatments: commercial feed; commercial feed plus hand mixed AA at 500; 750 and 1000 mg AA.kg⁻¹; SBM diet without AA; SBM diet plus 500; 750 and 1000 mg AA.kg⁻¹. The experiment was conducted in two experimental ponds (only SBM diet without AA placed in one pond and the rest in the other pond) with four replicate hapa each. Stocking density was 150 fish.m² and culture period was 5 months until market size was attained. The growth performance of snakehead and economic aspects were examined in this research.

Keywords: fish health, growth rate, snakehead, Vitamin C

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Authors: O.F. Akinmoladun, F.N. Fon, C.T. Mpendulo, O. Okoh

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The sustainability of livestock production is under threat as a result of water scarcity, fluctuating precipitation, and high environmental temperature. These combined stressors have impacted negatively on general animal production and welfare, necessitating a very reliable and cost-effective management practices, especially in arid and water-limited regions of the world. Instead of the above, this study was designed to investigate the growth performance and physiological response of water-restricted Xhosa ear-lobe goats fed diets supplemented with single or multiple vitamin C (VC) during summer. The total forty-eight goats used for the experiment were balanced for body weight and randomly assigned to the seven treatment groups (seven goats/treatment): GI (W100%); GII (W70%); GIII (W50%); GIV (W70%+3g/day VC); GV ((W50% +3g/day VC); GVI (W70%+3g/d VC+extra 5g on every eight-day); GVII (W50%+3g/d VC+extra 5g on every eight-day). The design was a complete randomized design and VC was administered per os. At the end of the 75-day feeding trial, GIII (W50%) animals were the most affected (P<0.05) and the effect was more pronounced in their body condition scores (BCs). Weight loss and depression in feed intake due to water restriction (P<0.05) were attenuated by VC treated groups (GIV-GVII). Changes in body thermal gradient (BTG) and rectal temperature (RcT) were similar (P>0.05) across the various experimental groups. The attenuation effect of VC was significant in responses to respiratory rate (RR) and cortisol. Supplementation of VC (either single or multiple) did not significantly (P>0.05) improve water restriction effect on body condition scores (BCs) and FAMACHA©. The current study found out that Xhosa ear lobe goats can adapt to the prevailing bioclimatic changes and limited water intake. However, supplementation of vitamin C can be beneficial at modulating these stressful stimuli. Continuous consistencies in the outcome of vitamin C on water-stressed animals can help validate recommendations especially to farmers in the arid and water-limited regions across the globe.

Keywords: vitamin C, Xhosa ear-lobe, thermotolerance, water stress

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Authors: B. Vikram, Y. Anu Leena, Y. Anu Neena, M. V. Krishna Rao, V. S. S. Kumar

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The industry is often criticized for inefficiencies in outcomes such as time and cost overruns, low productivity, poor quality and inadequate customer satisfaction. To enhance the chances for construction projects to be successful, selecting an able contractor is one of the fundamental decisions to be made by clients. The selection of the most appropriate contractor is a multi-criteria decision making (MCDM) process. In this paper, multi-attribute utility theory (MAUT) is employed utilizing the multiplicative form of utility function for ranking the prequalified contractors. Performance assessment criteria covering contracting company attributes, experience record, past performance, performance potential, financial stability and project specific criteria are considered for contractor evaluation. A case study of multistoried building for which four contractors submitted bids is considered to illustrate the applicability of multiplicative approach of MAUT to rank the prequalified contractors. The proposed MAUT decision making methodology can also be employed to other decision making situations.

Keywords: multi-attribute utility theory, construction industry, prequalification, contractor

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Authors: Ibrahim M. Labouta, Gina N. Tageldin, Salwa M. Fahmy, Hayam M. Ashour, Mounir A. Khalil, Tamer M. Ibrahim, Nefertiti A. El-Nikhely

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Bruton’s tyrosine kinase (BTK) is a critical effector molecule in B cell antigen receptor (BCR) signaling transduction. It regulates B cell proliferation, development and survival. Since BTK is widely expressed in many B cell leukaemias and lymphomas, targeting BTK by small molecules inhibitors became an attractive idea as new treatment modalities for B cell mediated hematologic malignancies. Ibrutinib is the 1st generation BTK inhibitor, approved by FDA for treatment of relapsed mantle cell lymphoma (MCL) and chronic lymphocytic leukemia (CLL). It binds irreversibly to the unique cysteine (Cys481) within the ATP-binding pocket of BTK. Besides ibrutinib, many irreversible covalent BTK inhibitors comprising pyrimidine nucleus such as spebrutinib (phase IIb) showed high selectivity and potency when compared to it. In this study, the designed compounds were based on 5-cyano-2-methylsulfanyl pyrimidine core and decorated with electrophilic warheads which are essential for the optimal activity for targeted covalent inhibition (TCI). However, modifications at pyrimidine C4 or C6 were made by introduction of substituted amines which are provided to behave differently. The synthesized derivatives were evaluated for their anticancer activity in leukemia cell lines (e.g. THP-1). Results showed that, some derivatives exhibited antiproliferative activity with IC50 ranged from 5-50 μM, The in vitro enzymatic inhibitory assay for these compounds against BTK is still under investigation. Nevertheless, we could conclude from the initial biological screening that, the synthesized 4 or 6-subsitituted aminopyrimidines represent promising and novel antileukemic agents. Meanwhile, further studies are still needed to attribute this activity through targeting BTK enzyme and inhibition of BCR signaling pathway.

Keywords: BTK inhibitors, hematologic malignancies, structure based drug design (SBDD), targeted covalent inhibitors (TCI)

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Authors: Miguel A. Jimenez Barros, Elyn L. Solano Charris, Luis E. Ramirez, Lauren Castro Bolano, Carlos Torres Barreto, Juliana Morales Cubillo

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This project sought to mitigate the high levels of water consumption in industrial processes in accordance with the water-rationing plan promoted at national and international level due to the water consumption projections published by the United Nations. Water consumption has three main uses, municipal (common use), agricultural and industrial where the latter consumes a minimum percentage (around 20% of the total consumption). Awareness on world water scarcity, a Colombian company responsible for generation of massive consumption products, decided to implement politics and techniques for water treatment, recycling, and reuse. The project consisted in a business technology program that permits a better use of wastewater caused by production operations. This approach reduces the potable water consumption, generates better conditions of water in the sewage dumps, generates a positive environmental impact for the region, and is a reference model in national and international levels. In order to achieve the objective, a process flow diagram was used in order to define the industrial processes that required potable water. This strategy allowed the industry to determine a water reuse plan at the operational level without affecting the requirements associated with the manufacturing process and even more, to support the activities developed in administrative buildings. Afterwards, the company made an evaluation and selection of the chemical and biological processes required for water reuse, in compliance with the Colombian Law. The implementation of the business technology program optimized the water use and recirculation rate up to 70%, accomplishing an important reduction of the regional environmental impact.

Keywords: bio-reactor, potable water, reverse osmosis, water treatment

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Authors: T. Poyai, P. Painmanakul, N. Chawaloesphonsiya, P. Dhanasin, C. Getwech, P. Wattana

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Drilling is a key activity in oil and gas exploration and production. Drilling always requires the use of drilling mud for lubricating the drill bit and controlling the subsurface pressure. As drilling proceeds, a considerable amount of cuttings or rock fragments is generated. In general, water or Water Based Mud (WBM) serves as drilling fluid for the top hole section. The cuttings generated from this section is non-hazardous and normally applied as fill materials. On the other hand, drilling the bottom hole to reservoir section uses Synthetic Based Mud (SBM) of which synthetic oils are composed. The bottom-hole cuttings, SBM cuttings, is regarded as a hazardous waste, in accordance with the government regulations, due to the presence of hydrocarbons. Currently, the SBM cuttings are disposed of as an alternative fuel and raw material in cement kiln. Instead of burning, this work aims to propose an alternative for drill cuttings management under two ultimate goals: (1) reduction of hazardous waste volume; and (2) making use of the cleaned cuttings. Soil washing was selected as the major treatment process. The physiochemical properties of drill cuttings were analyzed, such as size fraction, pH, moisture content, and hydrocarbons. The particle size of cuttings was analyzed via light scattering method. Oil present in cuttings was quantified in terms of total petroleum hydrocarbon (TPH) through gas chromatography equipped with flame ionization detector (GC-FID). Other components were measured by the standard methods for soil analysis. Effects of different washing agents, liquid-to-solid (L/S) ratio, washing time, mixing speed, rinse-to-solid (R/S) ratio, and rinsing time were also evaluated. It was found that drill cuttings held the electrical conductivity of 3.84 dS/m, pH of 9.1, and moisture content of 7.5%. The TPH in cuttings existed in the diesel range with the concentration ranging from 20,000 to 30,000 mg/kg dry cuttings. A majority of cuttings particles held a mean diameter of 50 µm, which represented silt fraction. The results also suggested that a green solvent was considered most promising for cuttings treatment regarding occupational health, safety, and environmental benefits. The optimal washing conditions were obtained at L/S of 5, washing time of 15 min, mixing speed of 60 rpm, R/S of 10, and rinsing time of 1 min. After washing process, three fractions including clean cuttings, spent solvent, and wastewater were considered and provided with recommendations. The residual TPH less than 5,000 mg/kg was detected in clean cuttings. The treated cuttings can be then used for various purposes. The spent solvent held the calorific value of higher than 3,000 cal/g, which can be used as an alternative fuel. Otherwise, the recovery of the used solvent can be conducted using distillation or chromatography techniques. Finally, the generated wastewater can be combined with the produced water and simultaneously managed by re-injection into the reservoir.

Keywords: drill cuttings, green solvent, soil washing, total petroleum hydrocarbon (TPH)

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Authors: A. H. Elkholy, D. M. Almutairi

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The successful and efficient execution of a forging process is dependent upon the correct analysis of loading and metal flow of blanks. This paper investigates the Upper Bound Technique (UBT) and its application in the analysis of open forging process when a possibility of blank bulging exists. The UBT is one of the energy rate minimization methods for the solution of metal forming process based on the upper bound theorem. In this regards, the kinematically admissible velocity field is obtained by minimizing the total forging energy rate. A computer program is developed in this research to implement the UBT. The significant advantages of this method is the speed of execution while maintaining a fairly high degree of accuracy and the wide prediction capability. The information from this analysis is useful for the design of forging processes and dies. Results for the prediction of forging loads and stresses, metal flow and surface profiles with the assured benefits in terms of press selection and blank preform design are outlined in some detail. The obtained predictions are ready for comparison with both laboratory and industrial results.

Keywords: forging, upper bound technique, metal forming, forging energy, forging die/platen

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Authors: Safeer Ahmad, Pratheek Sudhakran, M. Arif Kamal, Tarique Anwar

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In Healthcare facility designing, Efficient MEP services are very crucial because the built environment not only affects patients and family but also Healthcare staff and their outcomes. This paper shall cover the basics of Value engineering and its different phases that can be implemented to the MEP Designing stage for Healthcare facility optimization, also VE can improve the product cost the unnecessary costs associated with healthcare services. This paper explores Healthcare facility services and their Value engineering Job plan for the successful application of the VE technique by conducting a Workshop with end-users, designing team and associate experts shall be carried out using certain concepts, tools, methods and mechanism developed to achieve the purpose of selecting what is actually appropriate and ideal among many value engineering processes and tools that have long proven their ability to enhance the value by following the concept of Total quality management while achieving the most efficient resources allocation to satisfy the key functions and requirements of the project without sacrificing the targeted level of service for all design metrics. Detail study has been discussed with analysis been carried out by this process to achieve a better outcome, Various tools are used for the Analysis of the product at different phases used, at the end the results obtained after implementation of techniques are discussed.

Keywords: value engineering, healthcare facility, design, services

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Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini, Omid Seyed Esmaeili, Rouzbeh Kezemi, Noushin Mehrbod, Nazanin Vahed, Tahereh Hajiahmad, Noureddin Nakhostin Ansari

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Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of VR beside conventional rehabilitation versus conventional rehabilitation alone on spasticity and motor function in stroke patients. Materials and Methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran, in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were modified Ashworth scale, recovery stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in the combination group (P=0.003). Only wrist extension was varied between groups and was better in the combination group. The variables generally had a statistically significant difference (P < 0.05). Conclusion: Virtual reality plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: stroke, virtual therapy, rehabilitation, treatment

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Authors: Okunola Oluseye Ademola

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The study investigated various socio-cultural factors influencing adherence to antiretroviral drugs among people living with HIV in a University Teaching Hospital in South-western Nigeria. The objectives are to examine the perception of people living with HIV/AIDS (PLWHA) of antiretroviral therapy (ART) in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, investigate the influence of socio-cultural factors on adherence of PLWHA to treatment regimen in the study area and assess the prevalence of adherence to ART among PLWHA in the study area. It was a cross-sectional where both qualitative and quantitative research methods were adopted. The participants were HIV diagnosed patients attending clinic at the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife between the ages of 18 and 60 years. Also three healthcare delivery personnel working in the clinic were interviewed. Out of the 3007 patients receiving treatment, using Fischer’s formula of sampling technique, 336 patients living with HIV/AIDS were selected for the study. These participants had been on antiretroviral drugs for more than six months prior to the study and were selected using simple random sampling technique. Two focus group discussion sessions comprising of 10 male and 10 female living with HIV and currently on ART were conducted. These groups were purposively selected based on their being on ART for more than one year. Also in-depth interviews were conducted among three purposively selected healthcare givers (an experienced nurse, a doctor and a pharmacist) who are working in this clinic. All the participants were interviewed at the clinic on the various clinic days. Data were collected using a structured questionnaire, an interview guide and tape-recorder. The quantitative data were analysed using descriptive and inferential statistics. Content analysis was employed to analyse responses from IDI and FGD sessions. The findings from the study revealed a very positive perception to ART among PLWHA which was about 86.3% while the level of adherence to ART was 89.0% among the respondents. There was a very strong relationship between social and family supports and the degree of adherence to ART in the PLWHA. Nutrition, polygamy, difficulty in financing transportation fare to the clinic, unemployment, drug hawkers, religion, excuse duty from work and waking up very early were highlighted as socio-cultural barriers to adherence to ART. Fear of death, strong family support, religion belief, not seeking alternative treatment, absence of rituals and perceived improved health status were identified as very strong facilitators to adherence. The study concluded that to achieve a very optimal outcome in the management of HIV among PLWHA, various social and cultural contexts should be taken into consideration as this study was able to ascertain the influence of various socio-cultural factors militating and facilitating adherence to ART.

Keywords: ART, HIV, PLWHA, socio-cultural

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Authors: Miron Wolnicki

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In the past 75 years the world was either influenced by, competing with or learning from U.S. corporations. This is no longer true. As the economic power shifts from the West to the East, U.S. corporations are lagging behind Asian competitors. Moreover, U.S. statecraft fails to address this decline. In a world dominated by interventionist and neo-mercantilist states, having an ineffective non-activist government becomes a costly neoclassic delusion which weakens the world’s largest economy. American conservative economists continue talking about the superiority of the free market system in generating new technologies. The reality is different. The U.S. is sliding further into an overregulated, over-taxed, anti-business state. This paper argues that in order to maintain its economic strength and technological leadership, the U.S. must reform federal institutions to increase support for artificial intelligence and other cutting-edge technologies. The author outlines a number of institutional reforms, under one umbrella, which he calls the American Entrepreneurial State (AES). The AES will improve productivity and bring about coherent business strategies for the next 10-15 years. The design and inspiration for the AES come from the experience of successful statecraft examples in Asia and also other parts the global economy.

Keywords: post-neoliberal system, entrepreneurial state, government and economy, American entrepreneurial state

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Authors: Yih-Jer Wu, Ling-Lang Huang

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Shared decision-making (SDM) is a critical aspect of determining optimal medical strategies. However, current patient decision aids (PDAs) often prioritize evidence-based discussions over value-based considerations. Despite its significance, there is limited research addressing the 'value gap' between patients and healthcare providers. To address this gap, we developed the 'Patient-Doctor Relationship Questionnaire,' consisting of 12 questions. To explore potential variations in the patient-doctor value gap across different medical specialties, we conducted interviews with physicians, surgeons, and their respective patients, utilizing the questionnaire. Between 2020 and 2022, we interviewed a total of 144 patients and 19 doctors. Among the 12 questions, physicians demonstrated significant patient-doctor value gaps in 5 questions, while surgeons in 3 questions. Only one question turned out significant gaps in both physicians and surgeons. When asking both doctors and their patients to choose one from the following 6 answers (1. No issue significant; 2. Not knowing how to make a medical decision; 3. Not confident in the doctor’s clinical judgment; 4. Not knowing how to articulate one’s own condition; 5. Unable to afford medical expenses; 6. Not understanding what doctors explain) in response to the question “what the most significant issue is in the medical consultation”, over 50% of doctors chose “Not knowing how to make a medical decision” (physicians vs. patients, 50% vs. 11%, p=0.046; surgeon vs. patients, 83% vs. 29%, p=0.001), while significantly more patients chose “No issue significant” (10% vs. 52%, p=0.002; 0% vs. 33%, p<0.001, respectively). Our findings indicate that value gaps do exist between patients and doctors and that most patients in Taiwan "fully trust" their doctors' recommendations for medical decisions. However, when treatment outcomes are far from ideal, this overinflated "trust" may turn into frustration, which could become the catalyst for medical disputes. Doctors should spend more time having more effective communication with their patients, particularly regarding potentially dissatisfactory treatment outcomes. This study underscores the substantial variability in the patient-doctor value gap, often overlooked in SDM. Patients from different clinical backgrounds may hold values distinct from those of their healthcare providers. Bridging this value gap is imperative for achieving genuine and effective SDM.

Keywords: share-decision making, value gaps, communication, doctor-patient relationship

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Authors: Nitin Kumar

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Purpose: The current research work focuses mainly on evolving a delivery system for ginseng extract (GE), which in turn will ameliorate the neuroprotective potential by means of enhancing the ginsenoside (Rb1) bio-availability (BA). For more noteworthy enhancement in oral bioavailability (OBA) along with pharmacological properties, the drug carriers’ performance can be strengthened by utilizing phytosomes-loaded microspheres (PM) delivery system. Methods: For preparing the disparate phytosome complexes (F1, F2, and F3), an aqueous extract of ginseng roots (GR) along with phospholipids were reacted in disparate ratio. Considering the outcomes, F3 formulation (spray-dried) was chosen for preparing the phytosomes powder (PP), PM, and extract microspheres (EM). PM was made by means of loading of F3 into Gum Arabic (GA) in addition to maltodextrin polymer mixture, whereas EM was prepared by means of the addition of extract directly into the same polymer mixture. For investigating the neuroprotective effect (NPE) in addition to their pharmacokinetic (PK) properties, PP, PM, and EM formulations were assessed. Results: F3 formulation gave enhanced entrapment efficiency (EE) (i.e., 50.61%) along with good homogeneity of spherical shaped particle size (PS) (42.58 ± 1.4 nm) with least polydispersity index (PDI) (i.e., 0.193 ± 0.01). The sustained release (up to 24 h) of ginsenoside Rb1 (GRb1) is revealed by the dissolution study of PM. A significantly (p < 0.05) greater anti-oxidant (AO) potential of PM can well be perceived as of the diminution in the lipid peroxidase level in addition to the rise in the glutathione superoxide dismutase (SOD) in addition to catalase levels. It also showed a greater neuroprotective potential exhibiting significant (p < 0.05) augmentation in the nociceptive threshold together with the diminution in damage to nerves. A noteworthy enhancement in the relative BA (157.94%) of GRb1 through the PM formulation can well be seen in the PK studies. Conclusion: It is exhibited that the PM system is an optimistic and feasible strategy to enhance the delivery of GE for the effectual treatment of neuropathic pain.

Keywords: ginseng, neuropathic, phytosome, pain

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Authors: Christine Ysabelle G. Roman, Pauline Torres

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Background: Hypertrophic cardiomyopathy is a disease of marked heterogeneity. It is a genetically determined heart disease characterized by significant myocardium hypertrophy that results in diastolic dysfunction, left ventricular outflow tract obstruction, and an increased risk of arrhythmias. The primary treatment in patients with such conditions is negative inotropic drugs, such as beta-blockers, calcium channel antagonists, and disopyramide. However, for those who remain symptomatic and need septal reduction therapy, surgical septal myectomy or alcohol septal ablation are options. Case Summary: A 19 – year old female presented in the authors’ institution with easy fatigability. The consult was done a year prior, and 2D echocardiography was requested which showed concentric left ventricular hypertrophy, asymmetrically hypertrophied interventricular septum (IVS) with the largest diameter of 3.3cm & subaortic dynamic obstruction with a maximum gradient of 47 mmHg. A repeat echo a year later showed asymmetric septal hypertrophy (IVS measuring at 3cm) with the systolic anterior motion of anterior mitral valve leaflet and left ventricular outflow tract obstruction (peak gradient of 50mmHg). The patient then underwent alcohol septal ablation and was discharged stable after four days of admission. Conclusion: Hypertrophic obstructive cardiomyopathy, a cardiovascular genetic disease, results in various patterns of left ventricular hypertrophy and abnormality of mitral valve apparatus. The patient is managed medically initially. However, despite optimal drug therapy and significant left ventricular outflow tract obstruction, significant heart failure symptoms or syncope require invasive treatment.

Keywords: hypertrophic obstructive cardiomyopathy, left ventricular outflow tract obstruction, alcohol septal ablation, alcohol

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Authors: S. Bouchami, M.N. Lakhoua

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The automotive market is a dynamic market that continues to grow. That’s why several companies belonging to this sector adopt a quality improvement approach. Wanting to be competitive and successful in the environment in which they operate, these companies are dedicated to establishing a system of quality management to ensure the achievement of the objective quality, improving the products and process as well as the satisfaction of the customers. In this paper, the management of the quality and the improvement of a production line in an industrial company is presented. In fact, the project is divided into two essential parts: the creation of the technical line documentation and the quality assurance documentation and the resolution of defects at the line, as well as those claimed by the customer. The creation of the documents has required a deep understanding of the manufacturing process. The analysis and problem solving were done through the implementation of PDCA (Plan Do Check Act) and FTA (Fault Tree Analysis). As perspective, in order to better optimize production and improve the efficiency of the production line, a study on the problems associated with the supply of raw materials should be made to solve the problems of stock-outs which cause delays penalizing for the industrial company.

Keywords: quality management, documentary system, Plan Do Check Act (PDCA), fault tree analysis (FTA) method

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Authors: Fakhrul Anwar Zainol, Wan Norhayate Wan Daud, Zulhamri Abdullah, Mohd Rafi Yaacob

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Malaysia has made great strides in eradicating poverty. Based on the latest figures of the 9th Malaysian Plan Mid-term review, the overall hardcore poverty percentage is down to 0.7%, and only 3.6% of the Malaysian population is living below the overall poverty line. While in the past significant efforts had been taken by the government through various developmental project to alleviate poverty in rural area had proven successful. Today, urban poverty in Malaysia is an increasingly visible phenomenon due to rural-urban migration and the natural population growth in urban areas. Given the changing dimensions and emerging new forms of poverty as a result of unwanted effects of development there is a dire need to re-examine and re-visit urban poverty in Malaysia. Based on the leaders’ perceptions, this study affirmed that social entrepreneurship organizations in Malaysia have try to overcome the urban poverty through social entrepreneurship. The new framework has been developed from the results of this study. It shows that social entrepreneurship contributed to the organizational effectiveness. This result indicates that it is important to have social entrepreneurship in order to increase the socio economy and achieve the organization’s mission. Therefore, this study has proven that social entrepreneurship is beneficial to the Malaysian.

Keywords: Social Entrepreneurship, Organizational Effectiveness, Urban Poverty, Malaysia.

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Authors: Ying Sun, Biao Cheng, Qing Lu, Xuefei Tao, Xiaoyu Lai, Cheng Guo, Dan Wang

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Fibrinogen-like protein 2 (FGL2) has recently been identified to play an important role in inflammatory diseases such as atherosclerosis through a thrombin-dependent manner. Here, a murine monoclonal antibody was raised against the critical residue Ser(89) of FGL2, and the effects of the anti-FGL2 mAb (SPF89) were analyzed in human umbilical vein endothelial cells (HUVECs) and THP-1 cells. Firstly, it was proved that SPF89, which belongs to the IgG1 subtype with a KD value of 44.5 pM, could specifically show the expression levels of protein FGL2 in different cell lines of known target gene status. The lipopolysaccharide (LPS)-mediated endothelial cell proliferation was significantly inhibited with a decline of phosphorylation nuclear factor-κB (NF-κB) in a dose-dependent manner after SPF89 treatment. Furthermore, SPF89 reduced LPS-induced expression of adhesion molecules and inflammatory cytokines such as vascular cell adhesion molecule-1, tumor necrosis factor-α, Matrix metalloproteinase MMP-2, Integrin αvβ3, and interleukin-6 in HUVECs. In macrophage-like THP-1 cells, SPF89 effectively inhibited LPS and low-density lipoprotein-induced foam cell formation. However, these anti-inflammatory and anti-atherosclerotic effects of anti-FGL2 mAb in HUVECs and THP-1 cells were significantly reduced after treatment with an NF-κB inhibitor PDTC. All the above suggest, by efficiently inhibiting LPS-induced pro-inflammatory effects in vascular endothelial cells by attenuating NF-κB dependent pathway, the new anti-FGL2 mAb SPF89 could to be a potential therapeutic candidate for protecting the vascular endothelium against inflammatory diseases such as atherosclerosis. This work was supported by the Program of Sichuan Science and Technology Department (2017FZ0069) and Collaborative Innovation Program of Sichuan for Elderly Care and Health(YLZBZ1511).

Keywords: monoclonal antibody, fibrinogen like protein 2, inflammation, endothelial cells

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Authors: Muneeb Banday, Anukriti Dixit

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Change in organizations is viewed as a conversion process of the organizational functioning. One of the crucial elements of this conversion process is the employee resistance to organizational change. The existing literature on change resistance has generally treated resistance as a barrier or an opportunity for successful implementation of change. However, there is little empirical research exploring how resistance to change is managed. This may be partially due to difficulty in getting information on resistance to change. The top management does not divulge such information to avoid negative evaluation whereas employees face huge risk in sharing information related to resistance. The focus of the study is to understand how the organization under study dealt with the employee resistance to change. The conversion process is a story of how the organization went from one stage to another. We used narrative approach to change. Data was collected data through company visits and interviews. The interviews were transcribed, coded, and themes were identified. We focused on the strands that left huge scope for alternative interpretations than the dominant narrative of change prevalent in the organization. The study reveals that the top management strategically uses the legitimacy of leadership, roles of key employees, and rationality of change to manage resistance.

Keywords: employee resistance, legitimacy of leadership, narrative analysis, organisational change

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Authors: Hadeer Hegazy, Wael Ewieda, Ranin Soliman, Samah Elway, Asmaa Tawfik, Ragaa Sayed, Sahar Mousa

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The current healthcare system is facing major challenges in terms of cost, quality of care, and access to services. In response, the concept of value-based healthcare has emerged as a new approach to healthcare delivery. This concept puts the focus on patient values rather than on the traditional medical model of care. To achieve this, healthcare organizations must be agile and able to anticipate and respond quickly to changing needs. Agile management is essential for healthcare organizations to achieve value-based care, as it allows them to rapidly adjust their strategies to changing circumstances. Additionally, it is argued that agile management can help healthcare organizations gain a better understanding of the needs of their patients and develop better care delivery models. Besides, it can help healthcare organizations develop new services, innovate, and become more efficient. The authors provide evidence to support their argument, drawing on examples from successful value-based healthcare initiatives at children’s cancer hospital Egypt-57357. The paper offers insight into how agile management can be used to facilitate the shift towards value-based healthcare and how it can be used to maximize value in the healthcare system.

Keywords: value-based healthcare, agility in healthcare, nursing department, patients outcomes

Procedia PDF Downloads 754