Search results for: results of research

Authors: M. Kuzhko, M. Gumeniuk, D. Butov, T. Tlustova, O. Denysov, T. Sprynsian

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Abstract: The objective of this work was to study the efficacy and safety of inhaled nebulized chemotherapy in the treatment of patients with newly diagnosed pulmonary tuberculosis in comparison with standard antimycobacterial therapy. Materials and methods: The study involved 68 patients aged between 20 and 70 years with newly diagnosed pulmonary tuberculosis. Patients were allocated to two groups. The first (main, n=21) group of patients received standard chemotherapy and further 0.15 g of isoniazid and rifampicin 0.15 g inhaled through a nebulizer, also they received salmeterol 50 mcg + fluticasone propionate 250 mcg at 2 breaths twice a day for 2 months. The second (control, n=47) group of patients received standard chemotherapy, consisting of orally administered isoniazid (0.3 g), rifampicin (0.6 g), pyrazinamide (2 g), ethambutol (1.2 g) with a dose reduction after the intensive phase of the therapy. The anti-TB drugs were procured through the Ukraine’s centralized national supply system. Results: Intoxication symptoms in the first group reduced following 1.39±0.18 months, whereas in the second group, intoxication symptoms reduced following 2.7±0.1 months, p<.001. Moreover, respiratory symptoms regression in the first group was observed following 1.6±0.2 months, whereas in the second group – following 2.5±0.2 months, p<0.05. Bacillary excretion period evaluated within 1 month was reduced, as it was shown by 66.6±10.5% in the main group compared to 27.6±6.5%, p<0.05, in the control group. In addition, period of cavities healing was reduced to 2.9±0.2 months in the main group compared to 3.7±0.1 months, p<0.05, in the control group. Residual radiological lung damage findings (large residual changes) were observed in 22 (23.8±9.5 %) patients of the main group versus 24 (51.0±7.2 %) patients in the control group, p<0.05. After completion of treatment scar stenosis of the bronchi II-III art. diagnosed in 3 (14.2±7.8%) patients in main group and 17 (68.0±6.8%) - control group, p<0.05. The duration of hospital treatment was 2.4±0.4 months in main group and 4.1±0.4 months in control group, p<0.05. Conclusion: Administration of of inhaled nebulized chemotherapy in patients with newly diagnosed pulmonary tuberculosis resulted in a comparatively quick reduction of disease manifestation.

Keywords: inhaled nebulized chemotherapy, pulmonary tuberculosis, tuberculosis, treatment of tuberculosis

Procedia PDF Downloads 187

Authors: Omkar Gaonkar, Indumathi Nambi, Suresh G. Kumar

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The functional and morphological aspects of soil structure determine the soil quality. The dispersion of colloidal soil particles, especially the clay fraction and rupture of soil aggregates, both of which play an important role in soil structure development, lead to degradation of soil quality. The main objective of this work was to determine the effect of the behaviour of soil colloids on the agricultural soil structure and quality. The effect of commercial humic acid and soil natural organic matter on the electrical and structural properties of the soil colloids was also studied. Agricultural soil, belonging to the sandy loam texture class from northern part of India was considered in this study. In order to understand the changes in the soil quality in the presence and absence of humic acids, the soil fabric and structure was analyzed by X-ray diffraction (XRD), Fourier Transform Infrared (FTIR) Spectroscopy and Scanning Electron Microscopy (SEM). Electrical properties of natural soil colloids in aqueous suspensions were assessed by zeta potential measurements at varying pH values with and without the presence of humic acids. The influence of natural organic matter was analyzed by oxidizing the natural soil organic matter with hydrogen peroxide. The zeta potential of the soil colloids was found to be negative in the pH range studied. The results indicated that hydrogen peroxide treatment leads to deflocculation of colloidal soil particles. In addition, the humic acids undergoes effective adsorption onto the soil surface imparting more negative zeta potential to the colloidal soil particles. The soil hydrophilicity decreased in the presence of humic acids which was confirmed by surface free energy determination. Thus, it can be concluded that the presence of humic acids altered the soil fabric and structure, thereby affecting the soil quality. This study assumes significance in understanding soil aggregation and the interactions at soil solid-liquid interface.

Keywords: humic acids, natural organic matter, zeta potential, soil quality

Procedia PDF Downloads 236

Authors: James M. Wakiru, Liliane Pintelon, Peter Muchiri, Stanley Mburu

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Maintenance performance measurement (MPM) represents an integrated aspect that considers both operational and maintenance related aspects while evaluating the effectiveness and efficiency of maintenance to ensure assets are working as they should. Three salient issues require to be addressed for an asset-intensive organization to employ an MPM-based framework to optimize maintenance. Firstly, the organization should establish important perfomance metric(s), in this case the maintenance objective(s), which they will be focuss on. The second issue entails aligning the maintenance objective(s) with maintenance optimization. This is achieved by deriving maintenance performance indicators that subsequently form an objective function for the optimization program. Lastly, the objective function is employed in an optimization program to derive maintenance decision support. In this study, we develop a framework that initially identifies the crucial maintenance performance measures, and employs them to derive maintenance decision support. The proposed framework is demonstrated in a case study of a geothermal drilling rig, where the objective function is evaluated utilizing a simulation-based model whose parameters are derived from empirical maintenance data. Availability, reliability and maintenance inventory are depicted as essential objectives requiring further attention. A simulation model is developed mimicking a drilling rig operations and maintenance where the sub-systems are modelled undergoing imperfect maintenance, corrective (CM) and preventive (PM), with the total cost as the primary performance measurement. Moreover, three maintenance spare inventory policies are considered; classical (retaining stocks for a contractual period), vendor-managed inventory with consignment stock and periodic monitoring order-to-stock (s, S) policy. Optimization results infer that the adoption of (s, S) inventory policy, increased PM interval and reduced reliance of CM actions offers improved availability and total costs reduction.

Keywords: maintenance, vendor-managed, decision support, performance, optimization

Procedia PDF Downloads 116

Authors: Samih Ahmed, Guayente Minchot, Fritz King, Mikael Hallgren

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The stress ribbon system has numerous advantages that include but are not limited to increasing overall stiffness, control deflections, and reduction of materials consumption, which in turn, reduces the load and the cost. Nevertheless, its use is usually limited to bridges, in particular, pedestrian bridges; this can be attributed to the insufficient space that buildings' usually have for end supports, and/or back- stayed cables, that can accommodate the expected high pull-out forces occurring at the cables' ends. In this work, the roof of Västerås Travel Center, which will become one of the longest cable suspended roofs in the world, was chosen as a case study. The aim was to investigate the optimal technique to model the post-tensioned stress ribbon system for the roof structure using the FEM software SAP2000 and to assess any possible reduction in the pull-out forces, deflections, and concrete stresses. Subsequently, a conventional cable suspended roof was simulated using SAP2000, and compared to the post-tension stress ribbon system in order to examine the potential of the latter. Moreover, the effects of temperature loads and support movements on the final design loads were examined. Based on the study, a few practical recommendations concerning the construction method and the iterative design process, required to meet the architectural geometrical demands, are stated by the authors. The results showed that the post-tensioned stress ribbon system reduces the concrete stresses, overall deflections, and more importantly, reduces the pull-out forces and the vertical reactions at both ends by up to 16% and 11%, respectively, which substantially reduces the design forces for the support structures. The magnitude of these reductions was found to be highly correlated to the applied prestressing force, making the size of the prestressing force a key factor in the design.

Keywords: cable suspended, post-tension, roof structure, SAP2000, stress ribbon

Procedia PDF Downloads 153

Authors: Lanlan Xiao, Yang Liu, Shuo Chen, Bingmei Fu

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Most cancer-related deaths are due to metastasis. Metastasis is a complex, multistep processes including the detachment of cancer cells from the primary tumor and the migration to distant targeted organs through blood and/or lymphatic circulations. During hematogenous metastasis, the emigration of tumor cells from the blood stream through the vascular wall into the tissue involves arrest in the microvasculature, adhesion to the endothelial cells forming the microvessel wall and transmigration to the tissue through the endothelial barrier termed as extravasation. The narrow slit between endothelial cells that line the microvessel wall is the principal pathway for tumor cell extravasation to the surrounding tissue. To understand this crucial step for tumor hematogenous metastasis, we used Dissipative Particle Dynamics method to investigate an individual cell passing through a narrow slit numerically. The cell membrane was simulated by a spring-based network model which can separate the internal cytoplasm and surrounding fluid. The effects of the cell elasticity, cell shape and cell surface area increase, and slit size on the cell transmigration through the slit were investigated. Under a fixed driven force, the cell with higher elasticity can be elongated more and pass faster through the slit. When the slit width decreases to 2/3 of the cell diameter, the spherical cell becomes jammed despite reducing its elasticity modulus by 10 times. However, transforming the cell from a spherical to ellipsoidal shape and increasing the cell surface area only by 3% can enable the cell to pass the narrow slit. Therefore the cell shape and surface area increase play a more important role than the cell elasticity in cell passing through the narrow slit. In addition, the simulation results indicate that the cell migration velocity decreases during entry but increases during exit of the slit, which is qualitatively in agreement with the experimental observation.

Keywords: dissipative particle dynamics, deformability, surface area increase, cell migration

Procedia PDF Downloads 323

Authors: Shin Ku Kim, Yun Ah Oh, Eun Hee Seo, Chang Min Dae, Yun Jung Bae

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Objectives: The commonly used PRESS technique in magnetic resonance spectroscopy (MRS) has a limitation of incomplete water suppression. The recently developed sLASER technique is known for its improved effectiveness in suppressing water signal. However, no prior study has compared both sequences in a normal human brain. In this study, we firstly aimed to compare the performances of both techniques in brain MRS. Materials and methods: From January 2023 to July 2023, thirty healthy participants (mean age 38 years, 17 male, 13 female) without underlying neurological diseases were enrolled in this study. All participants underwent single-voxel MRS using both PRESS and sLASER techniques on 3T MRI. Two regions-of-interest were allocated in the left medial thalamus and left parietal white matter (WM) by a single reader. The SpectroView Analysis (SW5, Philips, Netherlands) provided automatic measurements, including signal-to-noise ratio (SNR) and peak_height of water, N-acetylaspartate (NAA)-water/Choline (Cho)-water/Creatine (Cr)-water ratios, and NAA-Cr/Cho-Cr ratios. The measurements from PRESS and sLASER techniques were compared using paired T-tests and Bland-Altman methods, and the variability was assessed using coefficients of variation (CV). Results: SNR and peak_heights of the water were significantly lower with sLASER compared to PRESS (left medial thalamus, sLASER SNR/peak_height 2092±475/328±85 vs. PRESS 2811±549/440±105); left parietal WM, 5422±1016/872±196 vs. 7152±1305/1150±278; all, P<0.001, respectively). Accordingly, NAA-water/Cho-water/Cr-water ratios and NAA-Cr/Cho-Cr ratios were significantly higher with sLASER than with PRESS (all, P< 0.001, respectively). The variabilities of NAA-water/Cho-water/Cr-water ratios and Cho-Cr ratio in the left medial thalamus were lower with sLASER than with PRESS (CV, sLASER vs. PRESS, 19.9 vs. 58.1/19.8 vs. 54.7/20.5 vs. 43.9 and 11.5 vs. 16.2) Conclusion: The sLASER technique demonstrated enhanced background water suppression, resulting in increased signals and reduced variability in brain metabolite measurements of MRS. Therefore, sLASER could offer a more precise and stable method for identifying brain metabolites.

Keywords: Magnetic resonance spectroscopy, Brain, sLASER, PRESS

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Authors: Chris Fersterer, Col Fay, Tobias Danielmeier, Kat Achterberg, Scott Willis

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New Zealand, an island nation, has an extensive coastline peppered with small communities of iconic buildings known as Bachs. Post WWII, these modest buildings were constructed by their owners as retreats and generally were small, low cost, often using recycled material and often they fell below current acceptable building standards. In the latter part of the 20^th century, real estate prices in many of these communities remained low and these areas became permanent residences for people attracted to this affordable lifestyle choice. The Blueskin Resilient Communities Trust (BRCT) is an organisation that recognises the vulnerability of communities in low lying settlements as now being prone to increased flood threat brought about by climate change and sea level rise. Some of the inhabitants of Blueskin Bay, Otago, NZ have already found their properties to be un-insurable because of increased frequency of flood events and property values have slumped accordingly. Territorial authorities also acknowledge this increased risk and have created additional compliance measures for new buildings that are less than 2 m above tidal peaks. Community resilience becomes an additional concern where inhabitants are attracted to a lifestyle associated with a specific location and its people when this lifestyle is unable to be met in a suburban or city context. Traditional models of social housing fail to provide the sense of community connectedness and identity enjoyed by the current residents of Blueskin Bay. BRCT have partnered with the Otago Polytechnic Design School to design a new form of community housing that can react to this environmental change. It is a longitudinal project incorporating participatory approaches as a means of getting people ‘on board’, to understand complex systems and co-develop solutions. In the first period, they are seeking industry support and funding to develop a transportable and fully self-contained housing model that exploits current technologies. BRCT also hope that the building will become an educational tool to highlight climate change issues facing us today. This paper uses the Climate Safe House (CSH) as a case study for education in architectural sustainability through experiential learning offered as part of the Otago Polytechnics Bachelor of Design. Students engage with the project with research methodologies, including site surveys, resident interviews, data sourced from government agencies and physical modelling. The process involves collaboration across design disciplines including product and interior design but also includes connections with industry, both within the education institution and stakeholder industries introduced through BRCT. This project offers a rich learning environment where students become engaged through project based learning within a community of practice, including architecture, construction, energy and other related fields. The design outcomes are expressed in a series of public exhibitions and forums where community input is sought in a truly participatory process.

Keywords: community resilience, problem based learning, project based learning, case study

Procedia PDF Downloads 275

Authors: Christos Lampropoulos, Maria Konsta, Vicky Dradaki, Irini Dri, Konstantina Panouria, Tamta Sirbilatze, Ifigenia Apostolou, Vaggelis Lambas, Christina Kordali, Georgios Mavras

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Objectives: Malnutrition in hospitalized patients is related to increased morbidity and mortality. The purpose of our study was to compare various nutritional scores in order to detect the most suitable one for assessing the nutritional status of elderly, hospitalized patients and correlate them with mortality and extension of admission duration, due to patients’ critical condition. Methods: Sample population included 150 patients (78 men, 72 women, mean age 80±8.2). Nutritional status was assessed by Mini Nutritional Assessment (MNA full, short-form), Malnutrition Universal Screening Tool (MUST) and short Nutritional Appetite Questionnaire (sNAQ). Sensitivity, specificity, positive and negative predictive values and ROC curves were assessed after adjustment for the cause of current admission, a known prognostic factor according to previously applied multivariate models. Primary endpoints were mortality (from admission until 6 months afterwards) and duration of hospitalization, compared to national guidelines for closed consolidated medical expenses. Results: Concerning mortality, MNA (short-form and full) and SNAQ had similar, low sensitivity (25.8%, 25.8% and 35.5% respectively) while MUST had higher sensitivity (48.4%). In contrast, all the questionnaires had high specificity (94%-97.5%). Short-form MNA and sNAQ had the best positive predictive value (72.7% and 78.6% respectively) whereas all the questionnaires had similar negative predictive value (83.2%-87.5%). MUST had the highest ROC curve (0.83) in contrast to the rest questionnaires (0.73-0.77). With regard to extension of admission duration, all four scores had relatively low sensitivity (48.7%-56.7%), specificity (68.4%-77.6%), positive predictive value (63.1%-69.6%), negative predictive value (61%-63%) and ROC curve (0.67-0.69). Conclusion: MUST questionnaire is more advantageous in predicting mortality due to its higher sensitivity and ROC curve. None of the nutritional scores is suitable for prediction of extended hospitalization.

Keywords: duration of admission, malnutrition, nutritional assessment scores, prognostic factors for mortality

Procedia PDF Downloads 334

Authors: Marriette Sakah, Samuel Gyamfi, Morkporkpor Delight Sedzro, Christoph Kuhn

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Ghana is experiencing rapid economic development and its cities command an increasingly dominant role as centers of both production and consumption. Cities run on energy and are extremely vulnerable to energy scarcity, energy price escalations and health impacts of very poor air quality. The overriding concern in Ghana and other West African states is bridging the gap between energy demand and supply. Energy efficiency presents a cost-effective solution for supply challenges by enabling more coverage with current power supply levels and reducing the need for investment in additional generation capacity and grid infrastructure. In Ghana, major issues for energy policy formulation in residential applications include lack of disaggregated electrical energy consumption data and lack of thorough understanding with regards to socio-economic influences on energy efficiency investment. This study uses a bottom up approach to estimate baseline electricity end-use as well as the energy consumption of best available technologies to enable estimation of energy-efficiency resource in terms of relative reduction in total energy use for Tema city, Ghana. A ground survey was conducted to assess the probable consumer behavior in response to energy efficiency initiatives to enable estimation of the amount of savings that would occur in response to specific policy interventions with regards to funding and incentives provision targeted at households. Results show that 16% - 54% reduction in annual electricity consumption is reasonably achievable depending on the level of incentives provision. The saved energy could supply 10000 - 34000 additional households if the added households use only best available technology. Political support and consumer awareness are necessary to translate energy efficiency resources into real energy savings.

Keywords: achievable energy savings, energy efficiency, Ghana, household appliances

Procedia PDF Downloads 203

Authors: AbdelRahman A. Faragalla, Mohamed H. Alqhtani, Mohamed M. M.Ahmed

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Saudi Arabia has currently been beset by a barrage of bizarre assemblages of subterranean termite fauna, inflicting heavy catastrophic havocs on human valued properties in various homes, storage facilities, warehouses, agricultural and horticultural crops including okra, sweet pepper, tomatoes, sorghum, date palm trees, citruses and many forest domains and green lush desert oases. The most pressing urgent priority is to use modern technologies to alleviate the painstaking obstacle of taxonomic identification of these injurious noxious pests that might lead to effective pest control in both infested agricultural commodities and field crops. Our study has indicated the use of DNA fingerprinting technologies, in order to generate basic information of the genetic similarity between 3 predominant families containing the most destructive termite species. The methodologies included extraction and DNA isolation from members of the major families and the use of randomly selected primers and PCR amplifications with the nucleotide sequences. GC content and annealing temperatures for all primers, PCR amplifications and agarose gel electrophoresis were also conducted in addition to the scoring and analysis of Random Amplification Polymorphic DNA-PCR (RAPDs). A phylogenetic analysis for different species using statistical computer program on the basis of RAPD-DNA results, represented as a dendrogram based on the average of band sharing ratio between different species. Our study aims to shed more light on this intriguing subject, which may lead to an expedited display of the kinship and relatedness of species in an ambitious undertaking to arrive at correct taxonomic classification of termite species, discover sibling species, so that a logistic rational pest management strategy could be delineated.

Keywords: DNA fingerprinting, Western Saudi Arabia, DNA primers, RAPD

Procedia PDF Downloads 418

Authors: D. O. Ramadan, R. S. Dwyer-Joyce

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The measurement of the interface conditions in a cutting tool contact is essential information for performance monitoring and control. This interface provides the path for the heat flux to the cutting tool. This elevate in the cutting tool temperature leads to motivate the mechanism of tool wear, thus affect the life of the cutting tool and the productivity. This zone is representative by the tool-chip interface. Therefore, understanding and monitoring this interface is considered an important issue in machining. In this paper, an acoustic emission (AE) technique was used to find the correlation between AE parameters and the tool-chip interface. For this reason, a response surface design (RSD) has been used to analyse and optimize the machining parameters. The experiment design was based on the face centered, central composite design (CCD) in the Minitab environment. According to this design, a series of orthogonal cutting experiments for different cutting conditions were conducted on a Triumph 2500 lathe machine to study the sensitivity of the acoustic emission (AE) signal to change in tool-chip contact length. The cutting parameters investigated were the cutting speed, depth of cut, and feed and the experiments were performed for 6082-T6 aluminium tube. All the orthogonal cutting experiments were conducted unlubricated. The tool-chip contact area was investigated using a scanning electron microscope (SEM). The results obtained in this paper indicate that there is a strong dependence of the root mean square (RMS) on the cutting speed, where the RMS increases with increasing the cutting speed. A dependence on the tool-chip contact length has been also observed. However there was no effect observed of changing the cutting depth and feed on the RMS. These dependencies have been clarified in terms of the strain and temperature in the primary and secondary shear zones, also the tool-chip sticking and sliding phenomenon and the effect of these mechanical variables on dislocation activity at high strain rates. In conclusion, the acoustic emission technique has the potential to monitor in situ the tool-chip interface in turning and consequently could indicate the approaching end of life of a cutting tool.

Keywords: Acoustic emission, tool-chip interface, orthogonal cutting, monitoring

Procedia PDF Downloads 476

Authors: Omnia F. Elkommos

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In the course of teaching stylistics to undergraduate students of the Department of English Language and Literature, Faculty of Arts and Humanities, the linguistic tool kit of theories comes in handy and useful for the better understanding of the different literary genres: Poetry, drama, and short stories. In the present paper, a model of teaching of stylistics is compiled and suggested. It is a collaborative group project technique for use in the undergraduate diverse specialisms (Literature, Linguistics and Translation tracks) class. Students initially are introduced to the different linguistic tools and theories suitable for each literary genre. The second step is to apply these linguistic tools to texts. Students are required to watch videos performing the poems or play, for example, and search the net for interpretations of the texts by other authorities. They should be using a template (prepared by the researcher) that has guided questions leading students along in their analysis. Finally, a practical analysis would be written up using the practical analysis essay template (also prepared by the researcher). As per collaborative learning, all the steps include activities that are student-centered addressing differentiation and considering their three different specialisms. In the process of selecting the proper tools, the actual application and analysis discussion, students are given tasks that request their collaboration. They also work in small groups and the groups collaborate in seminars and group discussions. At the end of the course/module, students present their work also collaboratively and reflect and comment on their learning experience. The module/course uses a drama play that lends itself to the task: ‘The Bond’ by Amy Lowell and Robert Frost. The project results in an interpretation of its theme, characterization and plot. The linguistic tools are drawn from pragmatics, and discourse analysis among others.

Keywords: applied linguistic theories, collaborative learning, cooperative principle, discourse analysis, drama analysis, group project, online acting performance, pragmatics, speech act theory, stylistics, technology enhanced learning

Procedia PDF Downloads 162

Authors: H. Hajimolahoseini, J. Hashemi, D. Redfearn

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Background: Catheter ablation is an effective therapy for symptomatic atrial fibrillation (AF). The intracardiac electrocardiogram (IEGM) collected during this procedure contains precious information that has not been explored to its full capacity. Novel processing techniques allow looking at these recordings from different perspectives which can lead to improved therapeutic approaches. In our previous study, we showed that variation in amplitude measured through Shannon Entropy could be used as an AF recurrence risk stratification factor in patients who received Ibutilide before the electrograms were recorded. The aim of this study is to further investigate the effect of Ibutilide on characteristics of the recorded signals from the left atrium (LA) of a patient with persistent AF before and after administration of the drug. Methods: The IEGMs collected from different intra-atrial sites of 12 patients were studied and compared before and after Ibutilide administration. First, the before and after Ibutilide IEGMs that were recorded within a Euclidian distance of 3 mm in LA were selected as pairs for comparison. For every selected pair of IEGMs, the Probability Distribution Function (PDF) of the amplitude in time domain and magnitude in frequency domain was estimated using the regression analysis. The PDF represents the relative likelihood of a variable falling within a specific range of values. Results: Our observations showed that in time domain, the PDF of amplitudes was fitted to a Gaussian distribution while in frequency domain, it was fitted to a Rayleigh distribution. Our observations also revealed that after Ibutilide administration, the IEGMs would have significantly narrower short-tailed PDFs both in time and frequency domains. Conclusion: This study shows that the PDFs of the IEGMs before and after administration of Ibutilide represents significantly different properties, both in time and frequency domains. Hence, by fitting the PDF of IEGMs in time domain to a Gaussian distribution or in frequency domain to a Rayleigh distribution, the effect of Ibutilide can easily be tracked using the statistics of their PDF (e.g., standard deviation) while this is difficult through the waveform of IEGMs itself.

Keywords: atrial fibrillation, catheter ablation, probability distribution function, time-frequency characteristics

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Authors: Zhang Jun, Zhai Shucheng, Bai Yaqiang, Zhang Guoping

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The Gymnarchus Niioticus fish(GNF) cruises generally with high efficiency by undulating ribbon-fin propulsion while keeping its body for straight line. The swing amplitude of GNF fins is usually in 60° to 90°, and in normal state the amplitude is close to 90°, only in the control of hovering or swimming at very low speed, the amplitude is smaller (about 60°). It provides inspiration for underwater robot design. In the paper, the unsteady flow of undulating ribbon-fin propulsion is numerical simulated by the dynamic grid technique including spring-based smoothing model and local grid remeshing to adapt to the fin surface significantly deforming, and the swing amplitude of fin ray reaches 850. The numerical simulation method is validated by thrust experiments. The spatial vortex structure and its evolution with phase angle is analyzed. The propulsion mechanism is investigated by comprehensive analysis of the hydrodynamics, vortex structure, and pressure distribution on the fin surface. The numerical results indicates that there are mainly three kinds of vortexes, i.e. streamwise vortex, crescent vortex and toroidal vortex. The intensity of streamwise vortex is the strongest among all kinds of vortexes. Streamwise vortexes and crescent vortexes all alternately distribute on the two sides of mid-sagittal plane. Inside the crescent vortexes is high-speed flow, while outside is low-speed flow. The crescent vortexes mainly induce high-speed axial jet, which produces the primary thrust. This is hydrodynamic mechanism undulating ribbon-fin propulsion. The streamwise vortexes mainly induce the vertical jet, which generates the primary heave force. The effect on hydrodynamics of main geometry and movement parameters including wave length, amplitude and advanced coefficients is investigated. A bionic underwater robot with bilateral undulating ribbon-fins is designed, and its navigation performance and maneuverability are measured.

Keywords: bionic propulsion, mobile robot, underwater robot, undulating ribbon-fins

Procedia PDF Downloads 271

Authors: Najade Sheriff, Malaz Elsaddig, Kevin Jones

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Background: Death in the first month of life accounts for an increasing proportion of under-five mortality. Advancement to reduce this number is being made across the globe; however, progress is slowest in sub-Saharan Africa. Objectives: The study aims to identify differences between neonatal deaths of inpatient babies born in a hospital facility in rural Uganda to those of neonates admitted from the community and to explore whether they can be used to risk stratify neonatal admissions. Results: A retrospective chart review was conducted on records for neonates admitted to the Special Care Baby Unit (SCBU) Kitovu Hospital from 1st July 2016 to 21st July 2017. A total of 442 babies were admitted and the overall neonatal mortality was 24.8% (40% inpatient, 37% community, 23% hospital referrals). 40% of deaths occurred within 24 hours of admission and the majority were male (63%). 43% of babies were hypothermic upon admission, a significantly greater proportion of which were inpatient babies born in labour ward (P=0.0025). Intrapartum related death accounted for ½ of all inpatient babies whereas complications of prematurity were the predominant cause of death in the community group (37%). Severe infection does not seem like a significant factor of mortality for inpatients (2%) as it does for community admissions (29%). Furthermore, with 52.5% of community admissions weighing < 1500g, very low birth weight (VLBW) may be a significant risk factor for community neonatal death. Conclusion: The neonatal mortality rate in this study is high, and the leading causes of death are all largely preventable. A high rate of inpatient birth asphyxiation indicates the need for good quality facility-based perinatal care as well as a greater focus on the management of hypothermia, such as Kangaroo care. Moreover, a reduction in preterm deliveries is necessary to reduce associated comorbidities, and monitoring for signs of infection is especially important for community admissions.

Keywords: community, mortality, newborn, Uganda

Procedia PDF Downloads 182

Authors: Hong Yu, Dirk Heider, Suresh Advani

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Increasing demands for high strength and lightweight materials in aircraft industry prompted the wide use of carbon composites in recent decades. Carbon composite laminates used on aircraft structures are subject to lightning strikes. Unlike its metal/alloy counterparts, carbon fiber reinforced composites demonstrate smaller electrical conductivity, yielding more severe damages due to Joule heating. The anisotropic nature of composite laminates makes the electrical and thermal conduction within carbon composite laminates even more complicated. Good understanding of the electrical conduction behavior of carbon composites is the key to effective lightning protection design. The goal of this study is to numerically and experimentally investigate the impact of ultra-high temperature induced by simulated lightning strike on the electrical conduction of carbon composites. A lightning simulator is designed to apply standard lightning current waveform to composite laminates. Multiple carbon composite laminates made from IM7 and AS4 carbon fiber are tested and the transient resistance data is recorded. A microstructure based resistor network model is developed to describe the electrical and thermal conduction behavior, with consideration of temperature dependent material properties. Material degradations such as thermal and electrical breakdown are also modeled to include the effect of high current and high temperature induced by lightning strikes. Good match between the simulation results and experimental data indicates that the developed model captures the major conduction mechanisms. A parametric study is then conducted using the validated model to investigate the effect of system parameters such as fiber volume fraction, inter-ply interface quality, and lightning current waveforms.

Keywords: carbon composite, joule heating, lightning strike, resistor network

Procedia PDF Downloads 218

Authors: Dona Pamoda W. Jayatunga, Veer Bala Gupta, Eugene Hone, Ralph N. Martins

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Being a neurodegenerative disorder, Alzheimer’s disease (AD) affects a majority of the elderly demented worldwide. The key risk factors for AD are age, metabolic syndrome, allele status of APOE gene, head injuries and lifestyle. The progressive nature of AD is characterized by symptoms of multiple cognitive deficits exacerbated over time, leading to death within a decade from clinical diagnosis. However, it is revealed that AD originates via a prodromal phase that spans from one to few decades before symptoms first manifest. The key pathological hallmarks of AD brains are deposition of amyloid beta (Aβ) plaques and neurofibrillary tangles (NFT). However, the yet unknown etiology of the disease fails to distinguish mitochondrial dysfunction between a cause or an outcome. The absence of early diagnosis tools and definite therapies for AD have permitted recruits of nutraceutical-based approaches aimed at reducing the risk of AD by modulating lifestyle or be used as preventive tools during AD prodromal state before widespread neurodegeneration begins. The objective of the present study was to investigate beneficial effects of luteolin, a plant-based flavone compound, against AD. The neuroprotective effects of luteolin on amyloid beta (Aβ) (1-42)-induced neurotoxicity was measured using cultured human neuroblastoma BE(2)-M17 cells. After exposure to 20μM Aβ (1-42) for 48 h, the neuroblastoma cells exhibited marked apoptotic death. Co-treatment of 20μM Aβ (1-42) with luteolin (0.5-5μM) significantly protected the cells against Aβ (1-42)-induced toxicity, as assessed by the MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2(4sulfophenyl)-2H-tetrazolium, inner salt; MTS] reduction assay and the lactate dehydrogenase (LDH) cell death assay. The results suggest that luteolin prevents Aβ (1-42)-induced apoptotic neuronal death. However, further studies are underway to determine its protective mechanisms in AD including the activity against tau hyperphosphorylation and mitochondrial dysfunction.

Keywords: Aβ (1-42)-induced toxicity, Alzheimer’s disease, luteolin, neuroblastoma cells

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Authors: Tahra ElObeid, Omnya Ahmed, Reem Al-Sharshani, Doaa Dalloul, Jannat Alnattei

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Background: Camelus dormedarius camels are also called ‘the Arabian camels’ and are present in the desert area of North Africa and the Middle East. Recently, camel’s milk has a great attention globally because of their proteins and peptides that have been reported to be beneficial for the health and in the management of many diseases. Objectives: This study was designed to investigate the antioxidant, antimicrobial activity and to evaluate the total phenolic content of camel’s milk proteins in Qatar. Methods: Fresh two camel’s milk samples from Omani breed and called Muhajer (camel’s milk A and B) were collected on the 1st of the December. Both samples were from the same location Al- Shahaniyah, Doha, Qatar, but from different local private farms and feeding system. Camel’s milk A and B were defatted by centrifugation and their proteins were extracted by acid and thermal precipitation. The antioxidant activity was determined by 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. Total phenolic compound (TPC) was evaluated by Folin-Ciocalteu reagent (FCR). On the other hand, the antimicrobial activity against eight different type of pathogenic bacteria was evaluated by disc diffusion method and the zone of inhibition was measured. Results: The of the total phenolic content of whole milk in both camel’s milk A and B were significantly the highest among the protein extracts. The % of the DPPH radical inhibition of casein protein in both camel’s milk A and B were significantly the highest among the protein extracts. In this study, there were marked changes in the antibacterial activity in the different camel milk protein extracts. All extracts showed bacterial overgrowth. Conclusion: The antioxidant activity of the camel milk protein extracts correlated to their unique phenolic compounds and bioactive protein peptides. The antimicrobial activity was not detected perhaps due to the technique, the quality, or the extraction method. Overall, camel's milk exhibits a high antioxidant activity, which is responsible for many health benefits besides the nutritional values.

Keywords: camels milk, antioxidant content, antimicrobial activity, proteins, Qatar

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Authors: Cheng Sim Quah, Sandra Phek Lin Sim

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This study examined how individuals in their respective teams contributed to innovation performance besides defining the term of innovation in their own respective views. This study also identified factors that motivated University staff to contribute to the innovation products. In addition, it examined whether there is a significant relationship between professional training level and the length of service among university staff towards innovation and to what extent do the two variables contributed towards innovative products. The significance of this study is that it revealed the strengths and weaknesses of the university staff when contributing to innovation performance. Stratified-random sampling was employed to determine the samples representing the population of lecturers in the study, involving 123 lecturers in one of the local universities in Malaysia. The method employed to analyze the data is through categorizing into themes for the open-ended questions besides using descriptive and inferential statistics for the quantitative data. This study revealed that two types of definition for the term “innovation” exist among the university staff, namely, creation of new product or new approach to do things as well as value-added creative way to upgrade or improve existing process and service to be more efficient. This study found that the most prominent factor that propel them towards innovation is to improve the product in order to benefit users, followed by self-satisfaction and recognition. This implies that the staff in the organization viewed the creation of innovative products as a process of growth to fulfill the needs of others and also to realize their personal potential. This study also found that there was only a significant relationship between the professional training level and the length of service of 4-6 years among the university staff. The rest of the groups based on the length of service showed that there was no significant relationship with the professional training level towards innovation. Moreover, results of the study on directional measures depicted that the relationship for the length of service of 4 - 6 years with professional training level among the university staff is quite weak. This implies that good organization management lies on the shoulders of the key leaders who enlighten the path to be followed by the staff.

Keywords: innovation, length of service, performance, professional training level, motivation

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Authors: Rosa L. Figueroa, Joselyn A. Hernández

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During the last couple of years, the Ministry of Health have been developing new health policies in order to regulate and improve in benefit of the patient the pharmaceutical system in our country. However, there are still some deficiencies in how medicines have been accessed, distributed, and sold. Therefore, it is necessary to empower the patient by offering new instances to improve access to drug information. This work introduces ‘the bioequivalent’ a medical drug search tool created to increase both diffusion and getting information about the therapeutic equivalence of medicines for the patient. The development of the search tool started with a study on the availability of sources of drug information accessible to the patient where advantages and disadvantages were analyzed. The information obtained was used to feed the functional design of the new tool. The design of the new tool shows an external interface that includes a header, body, sidebar and footer. The header has a menu containing ‘Home,’ ‘Who we are,’ and ‘Mission and vision.’ The Body contains the medical drug search tool, and the Sidebar is for the user logging in. It could be anonym, registered user, as well as, administrator. Anonym user could only use the tool. Registered users could add some information on existing medicines in the database; however, adding information will be restricted and limited to specific items and subject to administrator approval because the information added must be endorsed by the Chilean Public Health Institute. On the other hand, the administrator will have all the privileges, including creating or deleting drugs or information about them. The Bioequivalent was tested on different mobile devices, and no fails have been found. Moreover, a small survey was answered by ten people who tested the tool, and all of them agree that the tool was useful to get information about bioequivalent drugs, and they would recommend the tool to others. Nevertheless, an 80% of people who tested the tool says it was easy to use, and a 70% indicates that additional help is not required. These results are evidence that ‘the Bioequivalent’ may contribute to the knowledge about the therapeutic bioequivalence and bioequivalent drugs existing in Chile. As future work, the tool will be developed to make it available to the public for a first testing stage in a more massive scenario.

Keywords: collaborative database, bioequivalent drugs, search tool, web platform

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Authors: Farzaneh Askari, Jila Ganji, Sedigheh Hasani Moghadam

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Background and Aim: Endometriosis has been reported as one of the most common chronic gynecological conditions characterized by physical and psychological complications. Given that the impact of this disease on marital relationships and quality of life is multidimensional, the present review study aimed to reflect on the effect of psychosomatic aspects of endometriosis on marital relationships and quality of life. Materials and Methods: A narrative review methodology using keywords determined by the Medical Subject Headings (MeSH) thesaurus was adopted in this study. For this purpose, the databases of ScienceDirect, Scientific Information Database (SID), Google Scholar, and PubMed were searched by means of key terms including endometriosis, marital relationships, physical complications, psychological complications, and quality of life in English and Persian from 2005 to 2020. At the end of the search, 38 articles were retrieved, and ultimately a total number of 16 studies were recruited for this review. Results: A review of the selected articles demonstrated that endometriosis could affect marital relationships and quality of life among couples featuring in three different categories, i.e. “category I: physical health dimension” (chronic pelvic pain, dysmenorrhea, cramps but not period, reduction and loss of fertility), “category II: sexual health dimension” (no sexual intercourse, dyspareunia, lack of sexual satisfaction), and “category III: psychosocial health dimension” (negative self-esteem, low energy, sense of loneliness, depression, social isolation, insufficient sleep, marital distress, divorce and marriage breakdown, inability to work and socialize). Conclusion: In general, it is suggested to pay particular attention to psychosomatic aspects of marital problems in patients affected with endometriosis. Accordingly, implementing educational and counseling strategies to minimize the complications of this disease can provide the grounds for improving marital relationships and maintaining the quality of life in these patients.

Keywords: Endometriosis, marital relationships, psychosomatic complications, quality of life

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Authors: Apra Sinha

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The inverted U-shaped Environmental Kuznets curve (EKC) demonstrates(pollution-income relationship)that initially the pollution and environmental degradation surpass the level of income per capita; however this trend reverses since at the higher income levels, economic growth initiates environmental upgrading. However, what effect does increased environmental degradation has on growth is the missing feedback link which has not been addressed in the EKC hypothesis. This paper examines the missing feedback link in EKC hypothesis in Indian context by examining the casual association between fossil fuel consumption, carbon dioxide emissions and economic growth for India. Fossil fuel consumption here has been taken as a proxy of driver of economic growth. The casual association between the aforementioned variables has been analyzed using five interventions namely 1) urban development for which urbanization has been taken proxy 2) industrial development for which industrial value added has been taken proxy 3) trade liberalization for which sum of exports and imports as a share of GDP has been taken as proxy 4)financial development for which a)domestic credit to private sector and b)net foreign assets has been taken as proxies. The choice of interventions for this study has been done keeping in view the economic liberalization perspective of India. The main aim of the paper is to investigate the missing feedback link for Environmental Kuznets Curve Hypothesis before and after incorporating the intervening variables. The period of study is from 1971 to 2011 as it covers pre and post liberalization era in India. All the data has been taken from World Bank country level indicators. The Johansen and Juselius cointegration testing methodology and Error Correction based Granger causality have been applied on all the variables. The results clearly show that out of five interventions, only in two interventions the missing feedback link is being addressed. This paper can put forward significant policy implications for environment protection and sustainable development.

Keywords: environmental Kuznets curve hypothesis, fossil fuel consumption, industrialization, trade liberalization, urbanization

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Authors: E. Kotrotsiou, A. S. Topsioti, S. Mantzoukas, E. Dragioti, M. Gouva

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Introduction: The literature has demonstrated that individual and psychological factors have a direct effect on the perceptions and attitudes of women with cancer. Objectives: To investigate the relationship between the fear of cancer and anxiety. Aim: To examine the impact of the fear of cancer in women with state and trait anxiety of women. Methods: A community sample of 286 women (mean age 39.6 years, SD = 9.5 ranged 20-60) participated in the current study. The women completed a) State - Trait Anxiety Inventory (STAI) and b) questionnaire concerning socio-demographic information and questions for fear of cancer. Results: The perception of fear in women with cancer is statistically independent from their age (t–test, p = 0.58), their family status (χ2, p = 0.519), their place of residency (χ2, p = 0.148), the manifestation of gynecological cancer (χ2, p = 0.979) or the manifestation of any type of cancer in the family (χ2, p = 0.277). In contrast, it was observed that there was a dependence in relation to a total of phobias (χ2, p = 0.003), the fear of illness (χ2, p< 0.001) and the fear of heights (χ2, p = 0.004). Furthermore, the participants that responded that they feared cancer displayed greater level of stress both as situation (t=-3.462; p=0.001) and as a trait of their personality (t=-4.377; p<0.001), and at the same time they displayed greater levels of depression in comparisons with the other participants. Furthermore, following multiple linear regression analysis it was observed that the participants that responded positively to the question if they feared cancer had 8, 3 units greater stress level as a personality trait in comparison to women that responded negatively to the question if they feared cancer (B=8.3; p=0.016; R2=0.506). Conclusion: Women’s fear of cancer is statistically independent from their age, family status, place of residency, the manifestation of gynaecological cancer and with the manifestation of cancer any type in the family. In contrast, there is a dependency with the total of phobias, fear of illness and fear of heights. Women that state that they have a fear of cancer manifest greater levels of stress from the rest of the participants both as situation and as a trait of their personality (p = 0.001 and p< 0.001 accordingly). In specific, the study demonstrated that the participants that positively to the question if they feared cancer had 8,3 units greater stress level as a personality trait in comparison to women that responded negatively.

Keywords: fear, women health, anxiety, psychology, cancer

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Authors: H. Saikouk, D. Laux, Emmanuel Le Clézio, B. Lacroix, K. Audic, R. Largenton, E. Federici, G. Despaux

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Pressurized Water Reactor (PWR) fuel rods are made of ceramic pellets (e.g. UO2 or (U,Pu) O2) assembled in a zirconium cladding tube. By design, an initial gap exists between these two elements. During irradiation, they both undergo transformations leading progressively to the closure of this gap. A local and non destructive examination of the pellet/cladding interface could constitute a useful help to identify the zones where the two materials are in contact, particularly at high burnups when a strong chemical bonding occurs under nominal operating conditions in PWR fuel rods. The evolution of the pellet/cladding bonding during irradiation is also an area of interest. In this context, the Institute of Electronic and Systems (IES- UMR CNRS 5214), in collaboration with the Alternative Energies and Atomic Energy Commission (CEA), is developing a high frequency acoustic microscope adapted to the control and imaging of the pellet/cladding interface with high resolution. Because the geometrical, chemical and mechanical nature of the contact interface is neither axially nor radially homogeneous, 2D images of this interface need to be acquired via this ultrasonic system with a highly performing processing signal and by means of controlled displacement of the sample rod along both its axis and its circumference. Modeling the multi-layer system (water, cladding, fuel etc.) is necessary in this present study and aims to take into account all the parameters that have an influence on the resolution of the acquired images. The first prototype of this microscope and the first results of the visualization of the inner face of the cladding will be presented in a poster in order to highlight the potentials of the system, whose final objective is to be introduced in the existing bench MEGAFOX dedicated to the non-destructive examination of irradiated fuel rods at LECA-STAR facility in CEA-Cadarache.

Keywords: high-frequency acoustic microscopy, multi-layer model, non-destructive testing, nuclear fuel rod, pellet/cladding interface, signal processing

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Authors: D. Anderlini, G. Wallis

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Background: The number of people experiencing stroke is steadily increasing due to changes in diet and lifestyle, to longer life expectancy resulting in older population, to higher survival rates as a consequence of improvements during the acute phase. This study considers what risk factors might contribute to delayed entry to hospital for treatment. Methods: We analyzed data from 2472 patients admitted to the Stroke Unit of the Royal Brisbane Women's Hospital, Australia, between 2002 to 2011. Results: Previous studies have reported that factors which can contribute to delay include the patient’s age, the time of day, physical location, visit the GP instead of going to the emergency, means of transport, severity of symptoms and type of stroke. Contrary to findings of other studies, we found a strong correlation between side of lesion and delay in admission: patients with right hemisphere lesions had an average delay of 3.78 days, while patients with left hemisphere lesions had an average delay of 1.49 days. Damage to the right hemisphere generally ends in motor impairment in the non-dominant hand and no speech impediment. In contrast, left hemisphere lesions can result in deficit to; dominant hand function and aphasia which will be noticed even if their impact on performance is relatively minor. A finding which goes against many previous studies, is the fact that women get to the hospital much sooner than men, showing an average delay of 0.92 days in women vs. 3.36 days in men. Conclusion: Acute surgical-pharmacological therapies are most effective if applied immediately after stroke. Hence delays to admission can be crucial to the degree of recovery. The tendency of patients to overlook symptoms of right hemisphere lesion should be the target of information campaigns both for the general public and GPs. Why do men go to hospital so late? We don't know yet! Nevertheless an awareness plan specifically direct to male population should be on the agenda of Health Departments.

Keywords: gender, admission delay, stroke location, bioinformatics, biomedicine

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Authors: Seyyed Mohammad Amin Mousavi Sagharchi, Elham Javanroudi

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Introduction: Tuberculosis (TB) is a known disease with hidden features caused by Mycobacterium tuberculosis (MTB). This disease, which is one of the 10 deadliest in the world, has caused millions of deaths in recent decades. Furthermore, TB is responsible for infecting about 30% population of world. Like any infection, TB can activate the immune system by locating and colonization in the human body, especially in the alveoli. TB is granulomatosis, so MTB can absorb the host’s immune cells and other cells to form granuloma. Method: Different databases (e.g., PubMed) were recruited to prepare this paper and fulfill our goals to search and find effective papers and investigations. Results: Immune response to MTB is related to T cell killers and contains CD1, CD4, and CD8 T lymphocytes. CD1 lymphocytes can recognize glycolipids, which highly exist in the Mycobacterial fatty cell wall. CD4 lymphocytes and macrophages form granuloma, and it is the main line of immune response to Mycobacteria. On the other hand, CD8 cells have cytolytic function for directly killing MTB by secretion of granulysin. Other functions and secretion to the deal are interleukin-12 (IL-12) by induction of expression interferon-γ (INF-γ) for macrophages activation and creating a granuloma, and tumor necrosis factor (TNF) by promoting macrophage phagolysosomal fusion. Conclusion: Immune cells in battle with MTB are macrophages, dendritic cells (DCs), neutrophils, and natural killer (NK) cells. These immune cells can recognize the Mycobacterium by various receptors, including Toll-like receptors (TLRs), Nod-like receptors (NLRs), and C-type lectin receptors (CLRs) located in the cell surface. In human alveoli exist about 50 dendritic macrophages, which have close communication with other immune cells in the circulating system and epithelial cells to deal with Mycobacteria. Against immune cells, MTB handles some factors (e.g., cordfactor, O-Ag, lipoarabinomannan, sulfatides, and adenylate cyclase) and practical functions (e.g., inhibition of macrophages).

Keywords: mycobacterium tuberculosis, immune responses, immunological mechanisms, respiratory tuberculosis

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Authors: Adedapo Jepson Olumide, Kurowska Ewa, K. Schoeneich, Ikpokonte A. Enoch

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In this paper, subsurface temperature measured from continuous temperature logs were used to determine the geothermal gradient of NigerDelta sedimentary basin. The measured temperatures were corrected to the true subsurface temperatures by applying the American Association of Petroleum Resources (AAPG) correction factor, borehole temperature correction factor with La Max’s correction factor and Zeta Utilities borehole correction factor. Geothermal gradient in this basin ranges from 1.20C to 7.560C/100m. Six geothermal anomalies centres were observed at depth in the southern parts of the Abakaliki anticlinorium around Onitsha, Ihiala, Umuaha area and named A1 to A6 while two more centre appeared at depth of 3500m and 4000m named A7 and A8 respectively. Anomaly A1 describes the southern end of the Abakaliki anticlinorium and extends southwards, anomaly A2 to A5 were found associated with a NW-SE structural alignment of the Calabar hinge line with structures describing the edge of the Niger Delta basin with the basement block of the Oban massif. Anomaly A6 locates in the south-eastern part of the basin offshore while A7 and A8 are located in the south western part of the basin offshore. At the average exploratory depth of 3500m, the geothermal gradient values for these anomalies A1, A2, A3, A4, A5, A6, A7, and A8 are 6.50C/100m, 1.750C/100m, 7.50C/100m, 1.250C/100m, 6.50C/100m, 5.50C/100m, 60C/100m, and 2.250C/100m respectively. Anomaly A8 area may yield higher thermal value at greater depth than 3500m. These results show that anomalies areas of A1, A3, A5, A6 and A7 are potentially prospective and explorable for geothermal energy using abandoned oil wells in the study area. Anomalies A1, A3.A5, A6 occur at areas where drilled boreholes were not exploitable for oil and gas but for the remaining areas where wells are so exploitable there appears no geothermal anomaly. Geothermal energy is environmentally friendly, clean and reversible.

Keywords: temperature logs, geothermal gradient anomalies, alternative energy, Niger delta basin

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Authors: Anthony J. Kondracki, Bonzo Reddick, Jennifer L. Barkin

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Background: Many pregnancies in the United States are affected each year with the most common sexually transmitted infections (STIs), including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Treponema pallidum (TP, syphilis), and the rate of congenital syphilis has reached a 20-year high. We sought to estimate the prevalence of CT, NG, and TP in pregnancy and the risk of preterm birth (PTB) (<37 weeks gestation) and low birthweight (LBW) (<2500g) deliveries according to utilization of prenatal care (PNC) during the COVID-19 pandemic. Methods: This study was based on the 2020 National Center for Health Statistics (NCHS) Natality File restricted to singleton births (N=3,512,858). We estimated the prevalence of CT, NG, TP, PTBand LBW across timing and the number of prenatal care (PNC) visits attended. In multivariable logistic regression models, adjusted odds ratios of PTB and LBW were assessed according to STIs and PNC status. E-values, based on effect size estimates and the lower bound of the 95% confidence intervals (CIs) of the association, examined the potential impact of unmeasured confounding. Results: CT (1.8%) was most prevalent in pregnancy, followed by NG (0.3%) and TP (0.1%). The strongest predictors of PTB and LBW were maternal NG (12.2% and 12.1%, respectively), late initiation/no PNC (8.5% and 7.6%, respectively), and ≤10 prenatal visits (13.1% and 10.3%, respectively). The odds of PTB and LBW were 2.5- to 3-fold greater for each STI in women who received ≤10 compared to >10 prenatal visits. E-values demonstrated the minimum strength of potential unmeasured confounding necessary to explain away observed associations. Conclusions: Timely initiation and receipt of recommended number of prenatal visits benefits screening and treatment of all women for STIs, including NG to substantially reduce infant morbidity and mortality related to PTB and LBW among infants born during the COVID-19 pandemic.

Keywords: COVID-19 pandemic, sexually transmitted infections, preterm birth, low birthweight, prenatal care

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Authors: Rakan Hassan M. Alzahrani, Ziyad Alzahrani, Bader Bashrahil, Abdulrahman Elyasi, Abdullah a Ghaddaf, Rayan Alzahrani, Mohammed Alkathlan, Nawaf Alghamdi, Dakheelallah Almutairi

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Background: Corticosteroid irrigations, which regularly involve the off-label use of budesonide mixed with normal saline in high volume Sino-nasal irrigations, have been more commonly used in the management of post-operative chronic rhinosinusitis (CRS). Objective: This article attempted to measure the efficacy of post-operative budesonide nasal irrigation compared to normal saline-alone nasal irrigation in the management of chronic rhinosinusitis (CRS) through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: The databases PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched by two independent authors. Only RCTs comparing budesonide irrigation to normal saline alone irrigation for CRS with or without polyposis after functional endoscopic sinus surgery (FESS) were eligible. A random effect analysis model of the reported CRS-related quality of life (QOL) measures and the objective endoscopic assessment scales of the disease was done. Results: Only 6 RCTs met the eligibility criteria, with a total number of participants of 356. Compared to normal saline irrigation, budesonide nasal irrigation showed statically significant improvements in both the CRS-related quality of life (QOL) and the endoscopic findings (MD= -4.22 confidence interval [CI]: -5.63, -2.82 [P < 0.00001]), (SMD= -0.50 confidence interval [CI]: -0.93, -0.06 [P < 0.03]) respectively. Conclusion: Both intervention arms showed improvements in CRS-related QOL and endoscopic findings in post-FESS chronic rhinosinusitis with or without polyposis. However, budesonide irrigation seems to have a slight edge over conventional normal saline irrigation with no reported serious side effects, including hypothalamic-pituitary-adrenal (HPA) axis suppression.

Keywords: Budesonide, chronic rhinosinusitis, corticosteroids, nasal irrigation, normal saline

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Authors: M. M. Wickramasinghe

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Cholesterol and triglycerides are lipids, mainly essential to maintain the cellular structure of the human body. Cholesterol is also important for hormone production, vitamin D production, proper digestion functions, and strengthening the immune system. Excess fats in the blood circulation, known as hyperlipidemia, become harmful leading to arterial clogging and causing atherosclerosis. Aim of this research is to develop a treatment protocol to efficiently break down and maintain circulatory lipids by improving blood circulation without strenuous physical exercises while immersed in a tub of water. To achieve the target of strong exercise effect, this method involves generating powerful ozone bubbles to spin, collide, and burst in the water. Powerful emission of air into water is capable of transferring locked energy of the water molecules and releasing energy. This method involves water and air-based impact generated by pumping ozone at the speed of 46 lts/sec with a concentration of 0.03-0.05 ppt according to safety standards of The Federal Institute for Drugs and Medical Devices, BfArM, Germany. The direct impact of ozone bubbles on the muscular system and skin becomes the main target and is capable of increasing the heart rate while immersed in water. A total time duration of 20 minutes is adequate to exert a strong exercise effect, improve blood circulation, and stimulate the nervous and endocrine systems. Unstable ozone breakdown into oxygen release onto the surface of the water giving additional benefits and supplying high-quality air rich in oxygen required to maintain efficient metabolic functions. The breathing technique was introduced to improve the efficiency of lung functions and benefit the air exchange mechanism. The temperature of the water is maintained at 39c to 40c to support arterial dilation and enzyme functions and efficiently improve blood circulation to the vital organs. The buoyancy of water and natural hydrostatic pressure release the tension of the body weight and relax the mind and body. Sufficient hydration (3lts of water per day) is an essential requirement to transport nutrients and remove waste byproducts to process through the liver, kidney, and skin. Proper nutritional intake is an added advantage to optimize the efficiency of this method which aids in a fast recovery process. Within 20-30 days of daily treatment, triglycerides, low-density lipoproteins (LDL), and total cholesterol reduction were observed in patients with abnormal levels of lipid profile. Borderline patients were cleared within 10–15 days of treatment. This is a highly efficient system that provides many benefits and is able to achieve a successful reduction of triglycerides, LDL, and total cholesterol within a short period of time. Supported by proper hydration and nutritional balance, this system of natural treatment maintains healthy levels of lipids in the blood and avoids the risk of cerebral stroke, high blood pressure, and heart attacks.

Keywords: atherosclerosis, cholesterol, hydrotherapy, hyperlipidemia, lipid management, ozone therapy, triglycerides

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