Search results for: AIDS mortality rates

Authors: Ezinne K. Okoro, Takahiko Katoh, Yoko Kawamura, Stanley C. Meribe

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HIV infection in children is largely as a result of vertical transmission (mother to child transmission [MTCT]). Thus, elimination of mother to child transmission of HIV/AIDS is critical in eliminating HIV infection in children. In Nigeria, drawbacks such as; limited pediatric screening, limited human capital, insufficient advocacy and poor understanding of ART guidelines, have impacted efforts at combating the disease, even as treatment services are free. Prevention of Mother to Child Transmission (PMTCT) program relies on health workers who not only counsel pregnant women on first contact but can competently provide HIV-positive pregnant women with accurate information about the PMTCT program such as feeding techniques and drug adherence. In developing regions like Nigeria where health care delivery faces a lot of drawbacks, it becomes paramount to address these issues of poor PMTCT coverage by conducting a baseline assessment of the knowledge, practices and perceptions related to HIV prevention amongst healthcare workers in Nigeria. A descriptive cross-sectional study was conducted amongst 250 health workers currently employed in health facilities in Abuja, Nigeria where PMTCT services were offered with the capacity to carry out early infant diagnosis testing (EID). Data was collected using a self-administered, pretested, structured questionnaire. This study showed that the knowledge of PMTCT of HIV was poor (30%) among healthcare workers who offer this service day-to-day to pregnant women. When PMTCT practices were analyzed in keeping with National PMTCT guidelines, over 61% of the respondents reported observing standard practices and the majority (58%) had good attitudes towards caring for patients with HIV/AIDS. Although 61% of the respondents reported being satisfied with the quality of service being rendered, 63% reported not being satisfied with their level of knowledge. Predictors of good knowledge were job designation and level of educational attainment. Health workers who were more satisfied with their working conditions and those who had worked for a longer time in the PMTCT service were more likely to observe standard PMTCT practices. With over 62% of the healthcare workers suggesting that more training would improve the quality of service being rendered, this is a strong pointer to stakeholders to consider a ‘healthcare worker-oriented approach’ when planning and conducting PMTCT training for healthcare workers. This in turn will increase pediatric ARV coverage, the knowledge and effectiveness of the healthcare workers in carrying out appropriate PMTCT interventions and culminating in the reduction/elimination of HIV transmission to newborns.

Keywords: attitudes, HIV/AIDS, healthcare workers, knowledge, mother to child transmission, Nigeria, perceptions

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Authors: Lei Zhang, Tingting Xu, Jun He, Zhenyu Yan

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Email marketing is one of the most important segments of online marketing. It has been proved to be the most effective way to acquire and retain customers. The email content is vital to customers. Different customers may have different familiarity with a product, so a successful marketing strategy must personalize email content based on individual customers’ product affinity. In this study, we build our personalized email marketing strategy with three types of emails: nurture, promotion, and conversion. Each type of email has a different influence on customers. We investigate this difference by analyzing customers’ open rates, click rates and opt-out rates. Feature importance from response models is also analyzed. The goal of the marketing strategy is to improve the click rate on conversion-type emails. To build the personalized strategy, we formulate the problem as a reinforcement learning problem and adopt a Q-learning algorithm with variations. The simulation results show that our model-based strategy outperforms the current marketer’s strategy.

Keywords: email marketing, email content, reinforcement learning, machine learning, Q-learning

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Authors: P. C. Tewari, Parveen Kumar

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The paper describes the availability analysis of milling system of a rice milling plant using probabilistic approach. The subsystems under study are special purpose machines. The availability analysis of the system is carried out to determine the effect of failure and repair rates of each subsystem on overall performance (i.e. steady state availability) of system concerned. Further, on the basis of effect of repair rates on the system availability, maintenance repair priorities have been suggested. The problem is formulated using Markov Birth-Death process taking exponential distribution for probable failures and repair rates. The first order differential equations associated with transition diagram are developed by using mnemonic rule. These equations are solved using normalizing conditions and recursive method to drive out the steady state availability expression of the system. The findings of the paper are presented and discussed with the plant personnel to adopt a suitable maintenance policy to increase the productivity of the rice milling plant.

Keywords: availability modeling, Markov process, milling system, rice milling plant

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Authors: Lee Rui, Rajeev Ramachandran

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The approach to recurrent fevers in the paediatric or adolescent age group is not a straightforward one. Causes range from infectious diseases to rheumatological conditions to endocrinopathies, and are usually accompanied by weight loss rather than weight gain. We present an interesting case of a 16-year-old girl brought by her mother to the General Pediatrics Clinic for concerns of recurrent fever paired with significant weight gain over 1.5 years, with no identifiable cause found despite extensive work-up by specialists ranging from Rheumatologists to Oncologists. This case provides a learning opportunity on the approach to weight gain paired with persistent fevers in a paediatric population, one which is not commonly encountered and prompts further evaluation and consideration of less common diagnoses. In a span of 2 years, the girl’s weight had increased from 55 kg at 13 years old (75th centile) to 73.9 kg at 16 years old (>97th centile). About 1 year into her rapid weight gain, she started developing recurrent fevers of documented temperatures > 37.5 – 38.6 every 2-3 days, resulting in school absenteeism when she was sent home after temperature-taking in school found her to be febrile. The rapid onset of weight gain paired with unexplained fevers prompted the treating physician to consider the diagnosis of ROHHAD syndrome. Rapid onset obesity with hypoventilation, hypothalamic dysfunction and autonomic dysregulation (ROHHAD) syndrome is a rare disorder first described in 2007. It is characterized by dysfunction of the autonomic and endocrine system, characterized by hyperphagia and rapid-onset weight gain. This rapid weight gain is classically followed by hypothalamic manifestations with neuroendocrine deficiencies, hypo-ventilatory breathing abnormalities, and autonomic dysregulation. ROHHAD is challenging to diagnose with and diagnosis is made based mostly on clinical judgement. However if truly diagnosed, the condition is characterized by high morbidity and mortality rates. Early recognition of sleep disorders breathing and targeted therapeutic interventions helps limit morbidity and mortality associated with ROHHAD syndrome. This case poses an interesting diagnostic challenge and a diagnosis of ROHHAD has to be considered, given the serious complications that can come with disease progression while conditions such as Munchausen’s or drug fever remain as diagnoses of exclusion until we have exhausted all other possible conditions.

Keywords: pediatrics, endocrine, weight gain, recurrent fever, adolescent

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Authors: Jaylo Abalos, Sophia Zamora

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BACKGROUND: Various gastrointestinal (GI) symptoms, including diarrhea, nausea/vomiting and abdominal pain, have been reported in patients with Coronavirus disease 2019 (COVID-19). In this context, the presence of GI symptoms is variably associated with poor clinical outcomes in COVID-19. We aim to determine the outcomes of hospitalized COVID-19 patients with gastrointestinal symptoms. METHODOLOGY: This is a retrospective cohort study that used medical records of admitted COVID-19 patients from March 2020- March 2021 in a tertiary hospital in Pangasinan. Data records were evaluated for the presence of gastrointestinal manifestations, including diarrhea, nausea, vomiting and abdominal pain at the time of admission. Comparison between cases or COVID-19 patients presenting with GI manifestations to controls or COVID-19 patients without GI manifestation was made. RESULTS: Four hundred three patients were included in the study. Of these, 22.3% presented with gastrointestinal symptoms, while 77.7% comprised the study controls. Diarrhea was the most common GI symptom (10.4%). No statistically significant difference was observed in comorbidities and laboratory findings. Mortality was the primary outcome of the study that did not reach statistical significance between cases and controls (13.33% vs. 16.30%, p =0.621). There were also no significant differences observed in the secondary outcomes, mean length of stay, (14 [12-18 days] in cases vs 14 [12- 17.5 days] in controls, p = 0.716) and need for mechanical ventilation (12.22% vs 16.93%, p = 0.329). CONCLUSION: The results of the study revealed no association of the GI symptoms to poor outcomes, including a high rate of mortality, prolonged length of stay and increased need for mechanical ventilation.

Keywords: gastrointestinal symptoms, COVID-19, outcomes, mortality, length of stay

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Authors: Fahad Almehmadi, Abdullah Alrajhi, Bader K. Alaslab, Abdullah A. Al Qurashi, Hattan A. Hassani

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

Keywords: ARVD/C, cardiology, interventional cardiology, cardiac electrophysiology

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Authors: Malory Beaujolais

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Chlordecone is an organochlorine pesticide with a bishomocubane structure which led to high stability in organic matter. Microbial fuel cell is a type of electrochemical system that can convert organic matters into electricity thanks to electroactive bacteria. This technique has been used with mangrove swamp from Martinique to try to reduce chlordecone rates. Those experiments led to characterize the behavior of the electroactive biofilm formed at the cathode, without added redox mediator. The designed bioelectrochemical system seems to provide the necessary conditions for chlordecone degradation.

Keywords: bioelectrochemistry, bioremediation, chlordecone, mangrove swamp

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Authors: Sonia Anand Knowlton

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There are some cases where we as a society feel deeply uncomfortable with the use of Artificial Intelligence (AI) tools in the judicial decision-making process, and justifiably so. A perfect example is COMPAS, an algorithmic model that predicts recidivism rates of offenders to assist in the determination of their bail conditions. COMPAS turned out to be extremely racist: it massively overpredicted recidivism rates of Black offenders and underpredicted recidivism rates of white offenders. At the same time, there are certain uses of AI in the judicial decision-making process that many would feel more comfortable with and even support. Take, for example, a “super-breathalyzer,” an (albeit imaginary) tool that uses AI to deliver highly detailed information about the subject of the breathalyzer test to the legal decision-makers analyzing their drunk-driving case. This article evaluates the point at which a judge’s use of AI tools begins to undermine the public’s trust in the administration of justice. It argues that the answer to this question depends on whether the AI tool is in a role in which it must perform a moral evaluation of a human being.

Keywords: artificial intelligence, judicial reasoning, morality, technology, algorithm

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Authors: Mosito Jonas Seabela

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Breastfeeding in public has become a contentious issue in contemporary society. Mothers are often subjected to unfair discrimination and harassment for simply responding to their maternal instinct to breastfeed their infants. The unwillingness of society to accept public breastfeeding as a natural, non-sexual act is partly influenced by the imposition of a pornified and hypersexualised Western culture, which was imported to Africa through colonisation, enforced by the apartheid regime, and is now perpetuated by Western media. The imposition of the modern nuclear family on Africans, and the coerced aspiration to subscribe to bourgeois values, has eroded the moral standing of the traditional African family and its cultural values. Western-centric perceptions of African women have altered the experience of motherhood for many, commodifying the practice of breastfeeding. As a result, the use of bottles and infant formulas is often perceived as the preferred method, while breastfeeding in public is viewed as primitive, immoral, and unacceptable. This normative study seeks to answer the question of what ought to be done to preserve the dignity of African motherhood and protect their right to breastfeed in public. The African philosophy of Ubuntu is employed to advocate for the right to breastfeed in public. This moral philosophy posits that the western perception of a person seeks to isolate people from their environment and culture, thereby undermining the process of acquiring humanity, which fosters social cohesion. The Ubuntu philosophy embodies the aphorism, “umuntu ngumuntu nga bantu”, meaning “a person is a person through other persons”, signifying people’s interconnectedness and interdependence. The application of the key principles of Ubuntu, such as “survival, the spirit of solidarity, compassion, respect, and dignity” can improve human interaction and unite the public to support the government’s efforts to increase exclusive breastfeeding rates and reduce infant mortality rates. A doctrine called “Ubuntu Lactivism” is what the author proposes as a means to advocate for breastfeeding rights in fulfilment of African traditional values.

Keywords: ubuntu, breastfeeding, Afrocentric, colonization, culture, motherhood, imperialism, objectification

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Authors: Tadesse Kebede, Orkun Baris Kovanci

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Tomatoes leaf minor (Tutaabasoluta) is one of the most economically important insect pest in tomatoes production. The use of biological control such as entomopathogen fungi isolates would be a long-term and cost-effective solution to control insects pest. Therefore, identifying the most virulent and pathogenic entomopathogen fungi is one of the basic requirements for effective management options to combat Tomatoes leaf minor (Tutaabasoluta). Furthermore, the pathogenicity and virulence difference among entomopathogenfungus strains is not widely well investıgated. The current study was therefore initiated to test the pathogenicity of some entomopathogenic fungus isolates against Tutaabsoluta. The experiment was conducted at Bursa Uludag University, Agiculutre faculty, horticulture department glasshouse in 2020/2021. Tutabasoluta adult were collected, and masslarvae were reared in a growth chamber. Then, ten third instar larvae were inoculated with four entomopathogen fungi isolates (Beuaveriabassania Ak-10, Beuaveriabassania Ak-14, Metarhziumanisoplai Ak-11, and Metarhziumanisoplai Ak-12) with different inoculum suspension (0, 1x10⁶, 1x10⁷,,4 × 10⁸, 4× 10⁹ and 1×10¹⁰ conidia /ml) in a factorial experiment arranged in randomized complete block design with three replication. Mortality data assessment was done on the 3rd, 5thand 7th days after treatment and analyzed. The analysis of variance for mortality rate revealed significant variations (p<0.05) among entomoptahogen fungi isolates and conidia concentrations. The results revealed thatMetarhziumanisoplai Ak-12was found to show the lowest mortality percentage80.77%, highest LC50 2.3x108, and the longest incubation period, LT50, 4.9 and LT90, 9.9daysand considered to be less pathogenic fungi. On the other hand, Beuaveriabassania Ak-10 isolate showed the highest mortality percentage, 91%, and the lowest LT50, 4, and LT90, 7.6 values at 1×10¹⁰ conidia /ml, followed by Beuaveriabassania Ak-14 and being considered as the most aggressive bio-agent. Metarhziumanisoplai Ak-11 was determined as moderately virulent, having a mortality rate 27-81%. Results also revealed that among conidia concentrations, 1x10⁹ and 1x10¹⁰ suspensions is the most effective, while 1x10⁶ conidia/ml concentration is the least effective. Hence, results indicated that EPF tested were effective against T. absoluta larvae. As the current work revealed the potential variation among entomopathogen fungi isolates and concentration against third instar larvae.

Keywords: tuta absoluta, tomato, metarhizium anisopliae, beauveria bassiana, biological control

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Authors: Rasikha Ramanand, Priyanka Dixit

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Background: Continuum of maternal care which includes antenatal care, delivery care and postnatal care aids in averting maternal deaths. The objective of this paper is to identify the association between previous experiences of child death on Continuum of Care (CoC) of recent child. Further, the study aimed at understanding where the drop-out rate was high in the continuum. Methods: The study was based on the Nation-wide District Level Household and Facility Survey (DLHS-4) conducted during 2012-13, which provides information on antenatal care, delivery care, percentage of women who received JSY benefits, percentage of women who had any pregnancy, delivery, the place of delivery etc. The sample included women who were selected from the non-EAG states who delivered at least two children. The data were analyzed using SPSS 20.Binary Logistic regression was applied to the data in which the Continuum of Care (CoC) was the dependent variable while the independent variables were entered as the covariates. Results: A major finding of the study was the antenatal to delivery care period where the drop-out rates were high. Also, it was found that a large proportion of women did not receive any of the services along the continuum. Conclusions: This study has clearly established the relationship between previous history of child loss and continuum of maternal care.

Keywords: antenatal care, continuum of care, child loss, delivery care, India, maternal health care, postnatal care

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Authors: Saadia Elamin

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The quasi-universal use of smart phones with internet connection available all the time makes it a reflex action for translation undergraduates, once they encounter the least translation problem, to turn to the freely available web resource: Google Translate. Like for other translator resources and aids, the use of Google Translate needs to be moderated in such a way that it contributes to developing translation competence. Here, instead of interfering with students’ learning by providing ready-made solutions which might not always fit into the contexts of use, it can help to consolidate the skills of analysis and transfer which students have already acquired. One way to do so is by training students to adhere to the basic principles of translation work. The most important of these is that analyzing the source text for comprehension comes first and foremost before jumping into the search for target language equivalents. Another basic principle is that certain translator aids and tools can be used for comprehension, while others are to be confined to the phase of re-expressing the meaning into the target language. The present paper reports on the experience of making a measured and reasonable use of Google Translate in translation teaching at Prince Sultan University (PSU), Riyadh. First, it traces the development that has taken place in the field of translation in this age of information technology, be it in translation teaching and translator training, or in the real-world practice of the profession. Second, it describes how, with the aim of reflecting this development onto the way translation is taught, senior students, after being trained on post-editing machine translation output, are authorized to use Google Translate in classwork and assignments. Third, the paper elaborates on the findings of this case study which has demonstrated that Google Translate, if used at the appropriate levels of training, can help to enhance students’ ability to perform different translation tasks. This help extends from the search for terms and expressions, to the tasks of drafting the target text, revising its content and finally editing it. In addition, using Google Translate in this way fosters a reflexive and critical attitude towards web resources in general, maximizing thus the benefit gained from them in preparing students to meet the requirements of the modern translation job market.

Keywords: Google Translate, post-editing machine translation output, principles of translation work, translation competence, translation teaching, translator aids and tools

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Authors: Brian Bacia, Esther Githaiga, Teresia Kabucho, Paul Moses Ndegwa, Lucy Gichohi

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Purpose: The aim of the study is to ensure an appropriate mix of evidence-based prevention strategies geared towards the reduction of new HIV infections and the incidence of Sexually transmitted Illnesses Background: In Nakuru County, more than 90% of all HIV-infected patients are adults and on a single-dose medication-one pill that contains a combination of several different HIV drugs. Nakuru town has been identified as the hardest hit by HIV/Aids in the County according to the latest statistics from the County Aids and STI group, with a prevalence rate of 5.7 percent attributed to the high population and an active urban center. Method: 2 key studies were carried out to provide evidence for the effectiveness of antiretroviral therapy (ART) when used optimally on preventing sexual transmission of HIV. Discussions based on an examination, assessments of successes in planning, program implementation, and ultimate impact of prevention and treatment were undertaken involving health managers, health workers, community health workers, and people living with HIV/AIDS between February -August 2021. Questionnaires were carried out by a trained duo on ethical procedures at 15 HIV treatment clinics targeting patients on ARVs and caregivers on ARV prevention and treatment of pediatric HIV infection. Findings: Levels of AIDS awareness are extremely high. Advances in HIV treatment have led to an enhanced understanding of the virus, improved care of patients, and control of the spread of drug-resistant HIV. There has been a tremendous increase in the number of people living with HIV having access to life-long antiretroviral drugs (ARV), mostly on generic medicines. Healthcare facilities providing treatment are stressed challenging the administration of the drugs, which require a clinical setting. Women find it difficult to take a daily pill which reduces the effectiveness of the medicine. ART adherence can be strengthened largely through the use of innovative digital technology. The case management approach is useful in resource-limited settings. The county has made tremendous progress in mother-to-child transmission reduction through enhanced early antenatal care (ANC) attendance and mapping of pregnant women Recommendations: Treatment reduces the risk of transmission to the child during pregnancy, labor, and delivery. Promote research of medicines through patients and community engagement. Reduce the risk of transmission through breastfeeding. Enhance testing strategies and strengthen health systems for sustainable HIV service delivery. Need exists for improved antenatal care and delivery by skilled birth attendants. Develop a comprehensive maternal reproductive health policy covering equitability, efficient and effective delivery of services. Put in place referral systems.

Keywords: evidence-based prevention strategies, service delivery, human management, integrated approach

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Authors: Aicha Akrout, Amira Echtioui, Mohamed Ghorbel

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Pneumonia remains a significant global health concern, posing a substantial threat to human lives due to its contagious nature and potentially fatal respiratory complications caused by bacteria, fungi, or viruses. The reliance on chest X-rays for diagnosis, although common, often necessitates expert interpretation, leading to delays and potential inaccuracies in treatment. This study addresses these challenges by employing transfer learning techniques to automate the detection of lung diseases, with a focus on pneumonia. Leveraging three pre-trained models, VGG-16, ResNet50V2, and MobileNetV2, we conducted comprehensive experiments to evaluate their performance. Our findings reveal that the proposed model based on VGG-16 demonstrates superior accuracy, precision, recall, and F1 score, achieving impressive results with an accuracy of 93.75%, precision of 94.50%, recall of 94.00%, and an F1 score of 93.50%. This research underscores the potential of transfer learning in enhancing pneumonia diagnosis and treatment outcomes, offering a promising avenue for improving healthcare delivery and reducing mortality rates associated with this debilitating respiratory condition.

Keywords: chest x-ray, lung diseases, transfer learning, pneumonia detection

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Authors: Athar Mahmood, Asad Ali

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Management considerations including harvesting time and nitrogen application considerably influence the biomass yield, quality and biogas production. Therefore, a field study was conducted to determine the effect of various harvesting times and nitrogen rates on the biomass yield, quality and biogas yield of maize crop. This experiment was consisted of various harvesting times i.e., harvesting after 45, 55 and 65 days of sowing (DAS) and nitrogen rates i.e., 0, 100, 150 and 200 kg ha-1 respectively. The data indicated that maximum plant height, leaf area, dry matter (DM) yield, protein, acid detergent fiber, neutral detergent fiber, crude fiber contents and biogas yield were recorded 65 days after sowing while lowest was recorded 45 days after sowing. In contrary to that significantly higher chlorophyll contents were observed at 45 DAS. In case of nitrogen rates maximum plant height, leaf area, and DM yield, protein contents, ash contents, acid detergent fiber, neutral detergent fiber, crude fiber contents and chlorophyll contents were determined with nitrogen at the rate of 200 kg ha-1, while minimum was observed when no N was applied. Therefore, harvesting 65 DAS and N application @ 200 kg ha-1 can be suitable for getting the higher biomass and biogas production.

Keywords: chemical composition, fiber contents, biogas, nitrogen, harvesting time

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Authors: Omonov Jahongir Mahmatkulovic

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Purpose: To study the significance of D-dimer (DD), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen coagulation parameters (Fg) in predicting the course, severity and prognosis of COVID-19. Source and method of research: From September 15, 2021, to November 5, 2021, 93 patients aged 25 to 60 with suspected COVID-19, who are under inpatient treatment at the multidisciplinary clinic of the Tashkent Medical Academy, were retrospectively examined. DD, PT, APTT, and Fg were studied in dynamics and studied changes. Results: Coagulation disorders occurred in the early stages of COVID-19 infection with an increase in DD in 54 (58%) patients and an increase in Fg in 93 (100%) patients. DD and Fg levels are associated with the clinical classification. Of the 33 patients who died, 21 had an increase in DD in the first laboratory study, 27 had an increase in DD in the second and third laboratory studies, and 15 had an increase in PT in the third test. The results of the ROC analysis of mortality showed that the AUC DD was three times 0.721, 0.801, and 0.844, respectively; PT was 0.703, 0.845, and 0.972. (P<0:01). Conclusion”: Coagulation dysfunction is more common in patients with severe and critical conditions. DD and PT can be used as important predictors of mortality from COVID-19.

Keywords: Covid19, DD, PT, Coagulogram analysis, APTT

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Authors: Jiayue Yang

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Based on an analysis of China's database of certified disabled persons in 2021, this study reveals several key findings. Firstly, the proportion of certified mentally disabled persons among China's certified disabled population (Certification rate 1) shows a decreasing distribution from the East to the West and from the South to the North. Secondly, the spatial distribution of the number of mentally disabled persons per 1,000 people holding certificates (certification rate 2) shows a relatively scattered pattern, with significant variations observed between cities in the eastern region. However, on an overall scale, a south-north gradient can still be observed, with higher rates in the North and lower rates in the west, while the central region demonstrates higher rates compared to the western region. The variation in the rate of mentally handicapped certificates among regions is influenced not only by traditional culture and welfare level but also exhibits a certain correlation with the level of economic development.

Keywords: certified disabled persons, mentally disabled persons, spatial distribution, China

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Authors: Sabry Shaaban, Tom McNamara, Sarah Hudson

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This paper investigates the benefits of deliberately unbalancing both operation time means (MTs) and unreliability (failure and repair rates) for non-automated production lines.The lines were simulated with various line lengths, buffer capacities, degrees of imbalance and patterns of MT and unreliability imbalance. Data on two performance measures, namely throughput (TR) and average buffer level (ABL) were gathered, analyzed and compared to a balanced line counterpart. A number of conclusions were made with respect to the ranking of configurations, as well as to the relationships among the independent design parameters and the dependent variables. It was found that the best configurations are a balanced line arrangement and a monotone decreasing MT order, coupled with either a decreasing or a bowl unreliability configuration, with the first generally resulting in a reduced TR and the second leading to a lower ABL than those of a balanced line.

Keywords: unreliable production lines, unequal mean operation times, unbalanced failure and repair rates, throughput, average buffer level

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Authors: Awol Seid Ebrie

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HIV results as an incurable disease, AIDS. After a person is infected with virus, the virus gradually destroys all the infection fighting cells called CD4 cells and makes the individual susceptible to opportunistic infections which cause severe or fatal health problems. Several studies show that the CD4 cells count is the most determinant indicator of the effectiveness of the treatment or progression of the disease. The objective of this paper is to investigate the progression of the disease over time among patient under HAART treatment. Two main approaches of the generalized multilevel ordinal models; namely the proportional odds model and the nonproportional odds model have been applied to the HAART data. Also, the multilevel part of both models includes random intercepts and random coefficients. In general, four models are explored in the analysis and then the models are compared using the deviance information criteria. Of these models, the random coefficients nonproportional odds model is selected as the best model for the HAART data used as it has the smallest DIC value. The selected model shows that the progression of the disease increases as the time under the treatment increases. In addition, it reveals that gender, baseline clinical stage and functional status of the patient have a significant association with the progression of the disease.

Keywords: nonproportional odds model, proportional odds model, random coefficients model, random intercepts model

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Authors: Katherine Russell

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Background: Over recent decades the number of caesarean sections performed in the UK has continued to rise. The cause of the rising caesarean rate (CSR) is not well understood. However, one of the most heavily cited reasons is an increase in maternal request for caesarean section. Maternal request for caesarean section (CDMR) refers to a caesarean section performed on maternal request with no medical indication. The true rate of caesarean delivery on maternal request in the UK and its contribution to the caesarean section rate is not known. Methods: To elucidate current understanding of the cause of the rising caesarean section rate and the role of CDMR we conducted a systematic review of the literature. To determine the role of CDMR in the CSR at the PRH we conducted a retrospective observational study of the caesarean section rates and CDMR from 2009-2015. Results: We demonstrated a negative correlation between rates of elective sections and CDMR over the study period (-0.123). On average, there were more elective sections performed after 2011 (15.10% of all deliveries) than before 2011 (12.41% of all deliveries); this difference was statistically significant (p = < 0.001). There were more cases of CDMR after 2011 (1.39% of all deliveries) than before 2011 (0.85% of all deliveries). The difference in average rates of CDMR before and after 2011 was statistically significant (p ≤ 0.001). Conclusions: CDMR is only a minor contributor to the CSR at the PRH. However, it remains an important factor because it represents a target for the reduction of the CSR that is more manageable than other, more complex and ubiquitous causes of the rising CSR.

Keywords: cesarean section, maternal request for cesarean section, obstetrics, pre-natal health

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Authors: Samrat Paul, Satyajit Pahari, Krishnendu Basak, Amitava Roy

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Fishing is one of the pivotal livelihood activities, especially in developing countries. Today it is considered an important occupation for human society from the era of human settlement began. In simple terms, non-target catches of any species during fishing can be considered as ‘bycatch,’ and fishing bycatch is neither a new fishery management issue nor a new problem. Sundarban is one of the world’s largest mangrove land expanding up to 10,200 sq. km in India and Bangladesh. This largest mangrove biome resource is used by the local inhabitants commercially to run their livelihood, especially by forest fringe villagers (FFVs). In Sundarban, over-fishing, especially post larvae collection of wild Penaeus monodon, is one of the major concerns, as during the collection of P. monodon, different aquatic species are destroyed as a result of bycatch mortality which changes in productivity and may negatively impact entire biodiversity, of the ecosystem. Wild prawn seed collection gear like a small mesh sized net poses a serious threat to aquatic stocks, where the collection isn’t only limited to prawn seed larvae. As prawn seed collection processes are inexpensive, require less monetary investment, and are lucrative; people are easily engaged here as their source of income. Wildlife Trust of India’s (WTI) intervention in selected forest fringe villages of Sundarban Tiger Reserve (STR) was to estimate and reduce the mortality of aquatic bycatches by involving local communities in newly developed release method and their time engagement in prawn seed collection (PSC) by involving them in Alternate Income Generation (AIG). The study was conducted for their taxonomic identification during the period of March to October 2019. Collected samples were preserved in 70% ethyl alcohol for identification, and all the preserved bycatch samples were identified morphologically by the expertise of the Zoological Survey of India (ZSI), Kolkata. Around 74 different aquatic species, where 11 different species are molluscs, 41 fish species, out of which 31 species were identified, and 22 species of crustacean collected, out of which 18 species were identified. Around 13 different species belong to a different order, and families were unable to identify them morphologically as they were collected in the juvenile stage. The study reveals that for collecting one single prawn seed, eight individual life of associated faunas are being lost. Zero bycatch mortality is not practical; rather, collectors should focus on bycatch reduction by avoiding capturing, allowing escaping, and mortality reduction, and must make changes in their fishing method by increasing net mesh size, which will avoid non-target captures. But as the prawns are small in size (generally 1-1.5 inches in length), thus increase net size making economically less or no profit for collectors if they do so. In this case, returning bycatches is considered one of the best ways to a reduction in bycatch mortality which is a more sustainable practice.

Keywords: bycatch mortality, biodiversity, mangrove biome resource, sustainable practice, Alternate Income Generation (AIG)

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Authors: Taylor Harris

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Gustilo-anderson grade III tibial fractures are exquisitely difficult injuries to manage as they require extensive soft tissue repair in addition to fracture fixation. These injuries are best managed collaboratively by Orthopedic and Plastic surgeons. While utilizing an Orthoplastics approach has decreased the rates of adverse outcomes in these injuries, there is a large amount of variation in exactly how an Orthoplastics team approaches complex cases such as these. It is sometimes recommended that definitive bone fixation and soft tissue coverage be completed simultaneously in a single-stage manner, but there is a paucity of large scale studies to provide evidence to support this recommendation. It is the aim of this study to report the outcomes of a single-stage "fix-and-flap" approach through a systematic review of the available literature. Hopefully, this better informs an evidence-based Orthoplastics approach to managing open tibial fractures. Systematic review of the literature was performed. Medline and Google Scholar were used and all studies published since 2000, in English were included. 103 studies were initially evaluated for inclusion. Reference lists of all included studies were also examined for potentially eligible studies. Gustilo grade III tibial shaft fractures in adults that were managed with a single-stage Orthoplastics approach were identified and evaluated with regard to outcomes of interest. Exclusion criteria included studies with patients <16 years old, case studies, systemic reviews, meta-analyses. Primary outcomes of interest were the rates of deep infections and rates of limb salvage. Secondary outcomes of interest included time to bone union, rates of non-union, and rates of re-operation. 15 studies were eligible. 11 of these studies reported rates of deep infection as an outcome, with rates ranging from 0.98%-20%. The pooled rate between studies was 7.34%. 7 studies reported rates of limb salvage with a range of 96.25%-100%. The pooled rate of the associated studies was 97.8%. 6 reported rates of non-union with a range of 0%-14%, a pooled rate of 6.6%. 6 reported time to bone union with a range of 24 to 40.3 weeks and a pooled average time of 34.2 weeks, and 4 reported rates of reoperation ranging from 7%-55%, with a pooled rate of 31.1%. A few studies that compared a single stage to a multi stage approach side-by-side unanimously favored the single stage approach. Outcomes of Gustilo grade III open tibial fractures utilizing an Orthoplastics approach that is specifically done in a single-stage produce low rates of adverse outcomes. Large scale studies of Orthoplastic collaboration that were not completed in strictly a single stage, or were completed in multiple stages, have not reported as favorable outcomes. We recommend that not only should Orthopedic surgeons and Plastic surgeons collaborate in the management of severe open tibial fracture, but they should plan to undergo definitive fixation and coverage in a single-stage for improved outcomes.

Keywords: orthoplastic, gustilo grade iii, single-stage, trauma, systematic review

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Authors: Saad Bin Saeed, Fayzan Ahmed, Shahbaz Ahmed, Amjad Hussain

Abstract:

The aim of this study is to evaluate dynamic log files (Dynalogs) at different dose rates by dose-volume histograms (DVH) and used as a (QA) procedure of IMRT. Seven patients of phase one head and neck cancer with similar OAR`s are selected randomly. Reference plans of dose rate 300 and 600 MU/Min with prescribed dose of 50Gy in 25 fractions for each patient is made. Dynalogs produced by delivery of reference plans processed by in-house MATLAB program which produces new field files contain actual positions of multi-leaf collimators (MLC`s) instead of planned positions in reference plans. Copies of reference plans are used to import new field files generated by MATLAB program and renamed as Dyn.plan. After dose calculations of Dyn.plans for different dose rates, DVH, and multiple linear regression tools are used to evaluate reference and Dyn.plans. The results indicate good agreement of correlation between different dose rate plans. The maximum dose difference among PTV and OAR`s are found to be less than 5% and 9% respectively. The study indicates the potential of dynalogs to be used as patient-specific QA of IMRT at different dose rate.

Keywords: IMRT, dynalogs, dose rate, DVH

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Authors: Sunmyeng Kim

Abstract:

IEEE 802.11a/b/g standards provide multiple transmission rates, which can be changed dynamically according to the channel condition.Cooperative communications we reintroduced to improve the overallperformance of wireless LANs with the help of relay nodes with higher transmission rates. The cooperative communications are based on the fact that the transmission is much faster when sending data packets to a destination node through a relay node with higher transmission rate, rather than sending data directly to the destination node at low transmission rate. To apply the cooperative communications in wireless LAN, several MAC protocols have been proposed. Some of them can result in collisions among relay nodes in a dense network. In order to solve this problem, we propose a new protocol. Relay nodes are grouped based on their transmission rates. And then, relay nodes only in the highest group try to get channel access. Performance evaluation is conducted using simulation, and shows that the proposed protocol significantly outperforms the previous protocol in terms of throughput and collision probability.

Keywords: cooperative communications, MAC protocol, relay node, WLAN

Procedia PDF Downloads 457

Authors: Omar Ibrahim, Aly A. Gaafar, K. A. Ratib

Abstract:

Two field experiments in micro plots were carried out during the winter seasons of 2012/2013 and 2013/2014, Soil Salinity Laboratory, Alexandria, Egypt, to study the effect of three levels of salicylic acid (SA) as a growth regulator (0, 50, 100 ppm) and three rates of nitrogen fertilizer (75, 100, 125 kg N/feddan) on growth and yield of a spring wheat (Giza 168). The experimental design was a split plot with the main plots in randomized complete block design (RCBD) and four replicates. The results indicated that increasing nitrogen fertilizer rates resulted in insignificant effect on both plant height (cm) and grain weight/spike only. However, a significant effect was observed in all the other studied characters due to the increase in nitrogen fertilizer. On the other hand, increasing salicylic acid rates resulted in insignificant effect in all the studied characters except for chlorophyll a, chlorophyll b, number of grain/spike, and grain yield (gm/ plot). The highest effects on grain yield in wheat were obtained by the rate of 125 kg/feddan of nitrogen fertilizer and 100 ppm of salicylic acid. In conclusion, the data indicated that a high grain yield could be obtained by adding 100 kg/feddan of nitrogen fertilizer and spraying of 50 ppm of salicylic acid with no significant difference with the highest rates. Finally, the interaction had no significant effect on all the studied characters.

Keywords: growth regulator, nitrogen fertilizer, spring wheat, salicylic acid

Procedia PDF Downloads 108

Authors: Jeonghyun Chang, Taegeun Lee, Heungsup Sung, Yoon-Seon Lee, Youn-Jung Kim, Mi-Na Kim

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Background: Safety device has been applied to improve safety and performance of blood culture practice. BD vacutainer® Safety-Lokᵀᴹ blood collection sets with pre-attached holder (Safety-Lok) (BD, USA) was evaluated in the emergency room (ER) of a tertiary care hospital. Methods: From April to June 2017, interns and nurses in ER were surveyed for blood culture practices with a questionnaire before and after 2 or 3 weeks of experience of Safety-Lok. All of them participated in exercise workshop for 1 hour combined with video education prior to the initial survey. The blood volume, positive and contamination rates of Safety-Lok-drawn (SD) blood cultures were compared to those of overall blood cultures. Results: Eighteen interns and 30 nurses were enrolled. As a result of the initial survey, interns had higher rates of needlestick incidence (27.8%), carriage of the blood-filled syringe with needle (88.9%) and lower rates of vacutainer use (38.9%) than nurses (13.3%, 53.3%, and 60.0%). Interns preferred to use safety devices (88.9%) rather than nurses (40.0%). The number of overall blood cultures and SD blood cultures was 9,053 and 555, respectively. While the overall blood volume of aerobic bottles was 2.6±2.1 mL, those of SD blood cultures were 5.0±3.0 mL in aerobic bottles and 6.0±3.0 mL in anaerobic bottles. Positive and contamination rates were 6.5% and 0.72% with SD blood cultures and 6.2% and 0.3% with overall blood cultures. Conclusions: The introduction of the safety device would encourage healthcare workers to collect adequate blood volume as well as lead to safer practices in the ER.

Keywords: blood culture, needlestick, safety device, volume

Procedia PDF Downloads 189

Authors: Hasan Ustun Basaran

Abstract:

Diesel engines are widely used in transportation sector due to their high thermal efficiency. However, they also release high rates of NOₓ and PM (particulate matter) emissions into the environment which have hazardous effects on human health. Therefore, environmental protection agencies have issued strict emission regulations on automotive diesel engines. Recently, these regulations are even increasingly strengthened. Engine producers search novel on-engine methods such as advanced combustion techniques, utilization of renewable fuels, exhaust gas recirculation, advanced fuel injection methods or use exhaust after-treatment (EAT) systems in order to reduce emission rates on diesel engines. Although those aforementioned on-engine methods are effective to curb emission rates, they result in inefficiency or cannot decrease emission rates satisfactorily at all operating conditions. Therefore, engine manufacturers apply both on-engine techniques and EAT systems to meet the stringent emission norms. EAT systems are highly effective to diminish emission rates, however, they perform inefficiently at low loads due to low exhaust gas temperatures (below 250°C). Therefore, the objective of this study is to demonstrate that engine-out temperatures can be elevated above 250°C at low-loaded cases via cylinder disablement. The engine studied and modeled via Lotus Engine Simulation (LES) software is a six-cylinder turbocharged and intercooled diesel engine. Exhaust temperatures and mass flow rates are predicted at 1200 rpm engine speed and several low loaded conditions using LES program. It is seen that cylinder deactivation results in a considerable exhaust temperature rise (up to 100°C) at low loads which ensures effective EAT management. The method also improves fuel efficiency through reduced total pumping loss. Decreased total air induction due to inactive cylinders is thought to be responsible for improved engine pumping loss. The technique reduces exhaust gas flow rate as air flow is cut off on disabled cylinders. Still, heat transfer rates to the after-treatment catalyst bed do not decrease that much since exhaust temperatures are increased sufficiently. Simulation results are promising; however, further experimental studies are needed to identify the true potential of the method on fuel consumption and EAT improvement.

Keywords: cylinder disablement, diesel engines, exhaust after-treatment, exhaust temperature, fuel efficiency

Procedia PDF Downloads 166

Authors: Maryam Atapour

Abstract:

Chemical pesticides, which are widely used in agriculture, cause problems such as soil and water pollution, reducing biodiversity and creating pest resistance. These problems have led to increased attention to alternative and more sustainable methods such as natural-based pesticides. Herbal pesticides have been developed based on essential oils or extracts from different parts of plants, such as leaves, roots, and flowers. Herbal pesticides are compatible with the environment and can be used in integrated pest management programs. Despite the many benefits, herbal pesticides, especially essential oil-based compounds, have low durability in the environment, and their production costs are high, so the use of herbal extracts with appropriate formulations is more justified in all aspects. In the current study and based on the results of previous studies, aqueous and 70% ethanolic extract of Artemisia absinthium L. was prepared by the percolation method and formulated as an emulsion and water-soluble powder. To produce powder formulation, 20% maltodextrin was used with the spray-dryer method. Different concentrations of these compounds were sprayed on bushes infected with rose aphid Macrosiphum rosae (L.). Sampling was done randomly and the percentage of aphids’ mortality was checked. The results showed that the use of different concentrations of ethanolic extracts created a significant difference in the mortality rate of aphids, while water-soluble powder formulation caused less mortality. The current results showed that the extract of this plant has practical usability to control aphids, and with the appropriate formulation, it can be used as a good alternative to chemical pesticides.

Keywords: contact toxicity, formulation, extract, aphid, Artemisia absinthium.

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Authors: Behcet Al, Mustafa Bogan, Mehmet Murat Oktay, Suat Zengin, Hasan Bayram

Abstract:

Objective: In the last two decades there is a strong scientific interest regarding the role of aerosols for the Earth’s climate and associated changes. Aerosol particles are very important to the Earth-atmosphere climate system playing a crucial role in cloud and precipitation processes, air quality and climate. Here, we evaluated the association between saharran dust and emergency department admission, hospitalization, and mortality. Method: The records of admission to emergency department of Gaziantep University and the dust stroms of 31 months were studied. Patients admitted to ED at dust strom with chronic obstructive lung disease (COLD), asthma bronchiale (AB), serebrovascular events (SVE), acute myocardial infarction (AMI), stabile and unstabile angina pectoris (SAAP andUSAP); and the days with and without dust stroms were included. The study was realized from March 2010 to October 2012. The admission of three days before strom (group 1), during strom days (group 2) and three days after strom (group 3) were determined. The mean level of dust PM10 particulate was calculated, and the results were compared. Results: 5864 patients with chronic obstructive lung disease, asthma bronchiale, serebrovascular events, acute myocardial infarction, stabile and unstabile angyina pectoris admitted during the days with and without dust stroms. 28 dust stroms ocurred during 31 months. The totaliy of stroms continiued 78 days. Of admissions, 35.5% (n=2075) were in group1, 29.8% (n=1746) in group 2, and 34.8% (n=2043) were in group 3. The mean of PM10 for groups (group 1, 2 and 3) were 78.53 mg/m3 (range 19–276) particulate, 108.7 mg/m3 (range 34–631) particulate, and 60.9 mg/m3 (range 17–160) particulate respectively. The mean admission per a day for groups were 24.86, 22.55, and 24.50 respectively. The mortality was 12 in group 1, 12 in group 2, and 17 in grou 3. The hospitalization ratio for groups were 0.24, 0.27, and 0.27 respectively. Conclusion: However, the mean level of PM10 particulate for groups 2 (in dust strom days) is significantly higher (p=0.001) than the days before (group 1) and after (group 3) dust stroms, the mean admissions/day, hostilalization and mortality related to deseases (COLD, AB, SVE, AMI, SAAP andUSA) for group 2 is lower than the group 1 and group 3.

Keywords: Saharran dust, PM10 particulate, emergency department admission, mortality

Procedia PDF Downloads 389

Authors: Uwonkunda Jeanne, J. Godwin Prem Singh, Anjaneyalu Subbiah

Abstract:

HIV/AIDS is known to affect an individual not only physically but also mentally, socially, and financially. It is a syndrome that builds a vacuum in a person affecting his/her life as a whole.

Keywords: People living with HIV, social dysfunction, stigma, and Social support.

Procedia PDF Downloads 495