Search results for: treatment outcomes
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11247

Search results for: treatment outcomes

6447 Mechanical and Microstructural Properties of SA 210 Gr. C Pipes Welded by Tungsten Inert Gas

Authors: H. Demirtaş, İ. H. Kara, H. Ahlatcı

Abstract:

Welding failures of steel pipes in power plants usually occur in weld zones. This is similar for the economizer, water walls and superheaters in the power plants where SA 210 Gr. C steel pipes are used. Although these steel pipes have very good welding properties, the welding parameters are also important for the welding life. Welding processes of this pipes are carried out by TIG and SMA techniques. In this study SA 210 Gr. C steel pipes were welded by TIG method and investigated how PWHT affected the welding properties. The results show that this steel does not require post weld heat treatment.

Keywords: SA 210 Gr. C steel pipes, TIG welding, HAZ region, Widmanstatten ferrite

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6446 An Observation of Patient-Professional Communication in the Cambodian Dental Setting

Authors: Christina Tran, Lu Khoo, Andrea Waylen

Abstract:

Introduction: The evolution of the dental consultation from paternalism to partnership has been well documented in developed Western countries. Great emphasis is now placed on the importance of empowering patients to make decisions regarding their care, obtaining informed consent, and maintaining patient privacy and confidentiality. With the majority of communication occurring non-verbally, clinicians often adopt behaviours which suggest an approachable and positive attitude. However, evidence indicates that in Asia, a paternalistic model may be favored in medicine. The power imbalance occurring in doctor-patient relationships worldwide may be exacerbated by various factors in Southeast Asia: the strong hierarchical culture, and the large education gap between doctor and patient. Further insight into this matter can be gained by observing patient-dentist communication in Cambodia. The dentist:population ratio in Cambodia is approximately 1:33,000, with rural areas remaining extremely underserviced. We have carried out an observational study of communication in a voluntary dental clinic in Cambodia with the aim of describing whether the patient-dentist relationship follows a paternalistic or patient-centred model. Method: Over a period of two weeks, two clinicians provided dental care as part of a voluntary program in two Cambodian settings: a temporary, rural clinic and a permanent clinic in Phnom Penh. The clinicians independently recorded their experiences in diaries, making observations on the verbal and non-verbal communication between patients and staff. General observations such as the clinic environment were also made. The diaries were then compared and analyzed using a thematic approach. Results: The overall themes that emerged were regarding the clinic environment, verbal communication, and non-verbal communication. Regarding the clinic environment, the rural clinic was arranged in order to easily direct patients from one dentist to another, with little emphasis on continuous patient care. There was also little consideration for patient privacy: patients were often treated in the presence of many observers, including other waiting patients. However, the permanent clinic was structured to allow greater patient privacy, with continuous patient care occurring throughout the appointment. Regarding verbal communication, there was a strongly paternalistic approach to gaining consent and giving instruction. Patients rarely asked questions regarding their treatment, with dentists doing little to encourage patient involvement. Non-verbal communication between patients and dentists was generally paternalistic, with the dentist often addressing the supine patient from above. Patients often avoided making eye-contact, which may have indicated discomfort or lack of engagement. Both adult and paediatric patients rarely raised verbal concerns regarding pain during treatment, despite displaying non-verbal signs of experiencing pain. Anxious paediatric patients were sometimes managed with physical restraint by their mothers to facilitate treatment. Conclusion: Patient-professional communication in the Cambodian dental setting was observed to be generally paternalistic in nature, although more patient-centred aspects were observed in the established, urban setting. However, it should be noted that these observations are subjective in nature, and that the patients’ actual perceptions of their communication experience were unexplored. Further observations in variety of dental settings in Cambodia are needed before any definitive conclusions can be made.

Keywords: patient-dentist communication, paternalism, patient-centered, non-verbal communication

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6445 The Use of Artificial Intelligence in Language Learning and Teaching: A New Frontier in Education

Authors: Abdulaziz Fageeh

Abstract:

This study investigates the integration of artificial intelligence (AI) within the landscape of language learning and teaching, exploring its potential benefits and challenges. Employing a mixed-methods approach, the research draws upon a comprehensive literature review, case studies, user reviews, and in-depth interviews with educators and students. Findings demonstrate that AI tools, including language learning apps and writing assistants, can enhance personalization, improve writing skills, and increase accessibility to language learning resources. However, the study also highlights concerns regarding over-reliance on AI, potential accuracy and reliability issues, and ethical implications such as data privacy and potential bias. User and educator perspectives emphasize the importance of balancing AI with traditional teaching methods, fostering critical thinking skills, and addressing potential misuse. The study concludes by underscoring the need for ongoing research and development to ensure responsible AI integration in language learning, focusing on pedagogical strategies, ethical frameworks, and the long-term impact of AI on learning outcomes.

Keywords: artificial intelligence, language learning, education, technology, ethical considerations, user perceptions

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6444 Investigating the Application of Composting for Phosphorous Recovery from Alum Precipitated and Ferric Precipitated Sludge

Authors: Saba Vahedi, Qiuyan Yuan

Abstract:

A vast majority of small municipalities and First Nations communities in Manitoba operate facultative or aerated lagoons for wastewater treatment, and most of them use Ferric Chloride (FeCl3) or alum (usually in the form of Al2(SO4)3 ·18H2O) as coagulant for phosphorous removal. The insoluble particles that form during the coagulation process result in a massive volume of sludge which is typically left in the lagoons. Therefore, phosphorous, which is a valuable nutrient, is lost in the process. In this project, the complete recovery of phosphorous from the sludge that is produced in the process of phosphorous removal from wastewater lagoons by using a controlled composting process is investigated. Objective The main objective of this project is to compost alum precipitated sludge that is produced in the process of phosphorous removal in wastewater treatment lagoons in Manitoba. The ultimate goal is to have a product that will meet the characteristics of Class A biosolids in Canada. A number of parameters, including the bioavailability of nutrients in the composted sludge and the toxicity of the sludge, will be evaluated Investigating the bioavailability of phosphorous in the final compost product. The compost will be used as a source of P compared to a commercial fertilizer (monoammonium phosphate MAP) Experimental setup Three different batches of composts piles have been run using the Alum sludge and Ferric sludge. The alum phosphate sludge was collected from an innovative phosphorous removal system at the RM of Taché . The collected sludge was sent to ALS laboratory to analyze the C/N ratio, TP, TN, TC, TAl, moisture contents, pH, and metals concentrations. Wood chips as the bulking agent were collected at the RM of Taché landfill The sludge in the three piles were mixed with 3x dry woodchips. The mixture was turned every week manually. The temperature, the moisture content, and pH were monitored twice a week. The temperature of the mixtures was remained above 55 °C for two weeks. Each pile was kept for ten weeks to get mature. The final products have been applied to two different plants to investigate the bioavailability of P in the compost product as well as the toxicity of the product. The two types of plants were selected based on their sensitivity, growth time, and their compatibility with the Manitoba climate, which are Canola, and switchgrass. The pots are weighed and watered every day to replenish moisture lost by evapotranspiration. A control experiment is also conducted by using topsoil soil and chemical fertilizers (MAP). The experiment will be carried out in a growth room maintained at a day/night temperature regime of 25/15°C, a relative humidity of 60%, and a corresponding photoperiod of 16 h. A total of three cropping (seeding to harvest) cycles need be completed, with each cycle at 50 d in duration. Harvested biomass must be weighed and oven-dried for 72 h at 60°C. The first cycle of growth Canola and Switchgrasses in the alum sludge compost, harvested at the day 50, oven dried, chopped into bits and fine ground in a mill grinder (< 0.2mm), and digested using the wet oxidation method in which plant tissue samples were digested with H2SO4 (99.7%) and H2O2 (30%) in an acid block digester. The digested plant samples need to be analyzed to measure the amount of total phosphorus.

Keywords: wastewater treatment, phosphorus removal, composting alum sludge, bioavailibility of pohosphorus

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6443 Effects of a Student-Centered Approach to Assessment on Students' Attitudes towards 'Applied Statistics' Course

Authors: Anduela Lile

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The purpose of this cross sectional study was to investigate the effectiveness of teaching and learning Statistics from a student centered perspective in higher education institutions. Statistics education has emphasized the application of tangible and interesting examples in order to motivate students learning about statistical concepts. Participants in this study were 112 bachelor students enrolled in the ‘Applied Statistics’ course in Sports University of Tirana. Experimental group students received a student-centered teaching approach; Control group students received an instructor-centered teaching approach. This study found student-centered approach student group had statistically significantly higher assessments scores (52.1 ± 18.9) at the end of the evaluation compared to instructor-centered approach student group (61.8 ± 16.4), (t (108) = 2.848, p = 0.005). Results concluded that student-centered perspective can improve student positive attitude to statistical methods and to motivate project work. Therefore, findings of this study may be very useful to the higher education institutions to establish their learning strategies especially for courses related to Statistics.

Keywords: student-centered, instructor-centered, course assessment, learning outcomes, applied statistics

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6442 Metagenomic Analysis and Pharmacokinetics of Phage Therapy in the Treatment of Bovine Subclinical Mastitis

Authors: Vaibhav D. Bhatt, Anju P. Kunjadia, D. S. Nauriyal, Bhumika J. Joshi, Chaitanya G. Joshi

Abstract:

Metagenomic analysis of milk samples collected from local cattle breed, kankrej (Bos indicus), Gir (Bos indicus) and Crossbred (Bos indicus X Bos taurus) cattle harbouring subclinical mastitis was carried out by next-generation sequencing (NGS) 454 GS-FLX technology. Around 56 different species including members of Enterobacteriales, Pseudomonadales, Bacillales and Lactobacillales with varying abundance were detected in infected milk. The interesting presence of bacteriophages against Staphylococcus aureus, Escherichia coli, Enterobacter and Yersinia species were observed, especially Enterobacteria and E. coli phages (0∙32%) in Kankrej, Enterobacteria and Staphylococcus phages (1∙05%) in Gir and Staphylococcus phages (2∙32%) in crossbred cattle. NGS findings suggest that phages may be involved in imparting natural resistance of the cattle against pathogens. Further infected milk samples were subjected for bacterial isolation. Fourteen different isolates were identified, and DNA was extracted. Genes (Tet-K, Msr-A, and Mec-A) providing antibiotic resistance to the bacteria were screened by Polymerase Chain Reaction and results were validated with traditional antibiotic assay. Total 3 bacteriophages were isolated from nearby environment of the cattle farm. The efficacy of phages was checked against multi-drug resistant bacteria, identified by PCR. In-vivo study was carried out for phage therapy in mammary glands of female rats “Wister albino”. Mammary glands were infused with MDR isolates for 3 consecutive days. Recovery was observed in infected rats after intramammary infusion of sterile phage suspension. From day 4th onwards, level of C-reactive protein was significant increases up to day 12th . However, significant reduction was observed between days 12th to 18th post treatment. Bacteriophages have significant potential as antibacterial agents and their ability to replicate exponentially within their hosts and their specificity, make them ideal candidates for more sustainable mastitis control.

Keywords: bacteriophages, c-reactive protein, mastitis, metagenomic analysis

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6441 Effects of Methods of Confinement during Transportation of Market Pigs on Meat Quality

Authors: Pongchan Na-Lampang

Abstract:

The objective of this study was to compare the results of transport of slaughter pigs to slaughterhouse by 2 methods, i.e. individual confined and group confined on the truck on meat quality. The pigs were transported for 1 h on a distance of 70 km. The stocking densities were 0.35 m2/pig and 0.48 m2 for group and individual crate treatment, respectively. It was found that meat quality of pigs transported by 2 different methods as measured in terms of pH level (at 45 min and 48 hr post mortem), color (brightness, redness and yellowness) and water holding capacity was not significantly different.

Keywords: market pig, transportation, meat quality, confinement

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6440 Therapeutic Efficacy of Clompanus Pubescens Leaves Fractions via Downregulation of Neuronal Cholinesterases/NA⁺-K⁺ ATPase/IL-1 β and Improving the Neurocognitive and Antioxidants Status of Streptozotocin-Induced Diabetic Rats

Authors: Amos Sunday Onikanni, Bashir Lawal, Babatunji Emmanuel Oyinloye, Gomaa Mostafa-Hedeab, Mohammed Alorabi, Simona Cavalu, Augustine O. Olusola, Chih-Hao Wang, Gaber El-Saber Batiha

Abstract:

The increasing global burden of diabetes mellitus has called for the search for a therapeutic alternative that offers better activities and safety than conventional chemotherapy. Herein, we evaluated the neuroprotective and antioxidant properties of different fractions (ethyl acetate, N-butanol and residual aqueous) of Clompanus pubescens leaves in streptozotocin (STZ)-induced diabetic rats. Our results revealed a significant elevation in the levels of blood glucose, pro-inflammatory cytokines, lipid peroxidation, neuronal activities of acetylcholinesterase, butyrylcholinesterase, nitric oxide, epinephrine, norepinephrine, and Na+/K+-ATPase in diabetic non treated rats. In addition, decreased levels of enzymatic and non-enzymatic antioxidants were observed. Treatment with different fractions of C. pubescens leaves resulted in a significant reversal of the biochemical alteration and improved the neurocognitive deficit in STZ-induced diabetic rats. However, the ethyl-acetate fraction demonstrated higher activities than the other fractions and was characterized for its phytoconstituents, revealing the presence of Gallic acid (713.00 ppm), catechin (0.91 ppm), ferulic acid (0.98 ppm), rutin (59.82 ppm), quercetin (3.22 ppm) and kaempferol (4.07 ppm). Our molecular docking analysis revealed that these compounds exhibited different binding affinities and potentials for targeting BChE/AChE/ IL-1 β/Na+-K+-ATPase. However, only Kampferol and ferulic exhibited good drug-like, ADMET, and permeability properties suitable for use as a neuronal drug target agent. Hence, the ethyl-acetate fraction of C. pubescent leaves could be considered a source of promising bioactive metabolite for the treatment and management of cognitive impairments related to type II diabetes mellitus.

Keywords: diabetes mellitus, neuroprotective, antioxidant, pro-inflammatory cytokines

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6439 Effect of Supplementing Different Sources and Levels of Phytase Enzyme to Diets on Productive Performance for Broiler Chickens

Authors: Sunbul Jassim Hamodi, Muna Khalid Khudayer, Firas Muzahem Hussein

Abstract:

The experiment was conducted to study the effect of supplement sources of Phytase enzyme (bacterial, fungal, enzymes mixture) using levels (250, 500, 750) FTY/ kg feed to diets compared with control on the performance for one thousand fifty broiler chicks (Ross 308) from 1day old with initial weight 39.78 gm till 42 days. The study involved 10 treatments, three replicates per treatment (35 chicks/replicate). Treatments were as follows: T1: control diet (without any addition). T2: added bacterial phytase enzyme 250FTY/ kg feed. T3: added bacterial phytase enzyme 500FTY/ kg feed. T4: added bacterial phytase enzyme 750FTY/ kg feed. T5: added fungal phytase enzyme 250FTY/ kg feed. T6: added fungal phytase enzyme 500FTY/ kg feed. T7: added fungal phytase enzyme 750FTY/ kg feed. T8 added enzymes mixture 250U/ kg feed. T9: added enzymes mixture 500U/ kg feed. T10: added enzymes mixture 750U/ kg feed. The results revealed that supplementing 750 U from enzymes mixture to broiler diet increased significantly (p <0.05) body weight compared with (250 FTY bacterial phytase/Kgfeed), (750 FTY bacterial phytase/Kg feed), (750FTY fungal phytase/Kgfeed) at 6 weeks, also supplemented different sources and levels from phytase enzyme improved a cumulative weight gain for (500 FTY bacterial phytase/Kgfeed), (250FTY fungal phytase/Kgfeed), (500FTY fungal phytase/Kgfeed), (250 Uenzymes mixture/Kgfeed), (500 Uenzymes mixture/Kgfeed) and (750 U enzymes mixture/Kgfeed) treatments compared with (750 FTY fungal phytase/Kgfeed)treatment, about accumulative feed consumption (500 FTY fungal phytase/Kgfeed) and (250 Uenzymes mixture/Kgfeed) increased significantly compared with control group and (750FTY fungal phytase/Kgfeed) during 1-6 weeks. There were significantly improved in cumulative feed conversion for (500U enzymes mixture/Kgfeed) compared with the worse feed conversion ratio that recorded in (250 FTY bacterial phytase/Kgfeed). No significant differences between treatments in internal organs relative weights, carcass cuts, dressing percentage and production index. Mortality was increased in (750FTY fungal phytase/Kgfeed) compared with other treatments.

Keywords: phytase, phytic acid, broiler, productive performance

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6438 Understanding Context and Its Effects in the Implementation of Modern Foreign Language Curriculum in Vietnam

Authors: Ngoc T. Bui

Abstract:

The key issue for teachers of a modern foreign language is the creation of a pedagogic environment, and this means that an understanding of context is vital. A pedagogic environment addresses the following: time, feedback, relations with other people, curriculum integration, forms of knowledge, resources and control in the pedagogic relationship. In this light, the multiple case study of the implementation of a modern foreign language curriculum focuses on exploring Vietnamese contexts and participants’ perceptions of factors that may affect their implementation process in order to examine thoroughly how the communicative language teaching (CLT) curriculum is being implemented in second language classrooms. A mixed methods approach is utilized to investigate contextual and personal factors that may affect teachers’ implementation of curriculum and pedagogical reform in Vietnam. This project therefore has the capability to inform stakeholders of useful information and identify further changes and measures to solve potential problems to ensure the achievement of the curriculum goals. The expected outcomes may also lead to intercultural language teaching guidelines to support english as a foreign language (EFL) teachers with curriculum design, planning and how to create pedagogic environment to best implement it.

Keywords: communicative language teaching, context, curriculum implementation, modern foreign language, pedagogic environment

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6437 Effluent from Royal LERD Wastewater Treatment Systems to Furnish Nutrients for Phytoplankton to Generate the Abundance of Hard Clam (Meretrix spp.) on Muddy Beach

Authors: O. Phewnil, S. Khowhit, W. Inkapatanakul, A. Boutson, K. Chunkao, O. Chueawong, T. Pattamapitoon, N. Chanwong, C. Nimpee

Abstract:

The King’s Royally Initiated Laem Phak Bia Environmental Research and Development Project (“the Royal LERD Project”) is located in Laem Phak Bia Sub-District, Ban Laem District, Phetchaburi Province, Thailand. Phetchaburi municipal wastewater was treated with a simple technology by using aquatic plants, constructed wetland, oxidation ponds through a nature-by-nature process. The effluent from the Royal LERD Project was discharged into Laem Phak Bia muddy beach. The soil sediment samples were collected from two zones (200 and 600 meters from the coast of the beach), and tested for cation-exchange capacity (CEC), pH and organic matter and soil particles content. The marine water samples were also collected from the beach in wet and dry seasons and analyzed for its quality and compositions, including but not limited to, biochemical oxygen demand (BOD), dissolved oxygen (DO), suspended solids (SS), nutrients, heavy metals (As, Cd, Cr, Hg, and Pb), and phytoplankton at high and low tides. The soil texture was sandy loam with high concentration of calcium and magnesium which showed a property of base (pH 8). The marine water was qualified with the standard limits of coastal water quality. A dominant species was Coscinodiscus sp. It was found approximately 70.46% of total phytoplankton species in Meretrix casta gastrointestinal tract. The concentration of the heavy metals (As, Cd, Cr, Hg, Ni and Pb) in the tissues and water content of two species of hard clams indicated that heavy metals in Meretrix casta were higher than those in Meretrix meretrix. However, the heavy metals in both species were under the standard limits and safe for consumption. It can be concluded that nutrients in effluent from the wastewater treatment systems play important role in promoting the growth of phytoplankton and generating abundance of hard clams on muddy beach.

Keywords: wastewater, phytoplankton, hard clam (Meretrix spp.), muddy beach

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6436 Health Risk Assessment of Trihalogenmethanes in Drinking Water

Authors: Lenka Jesonkova, Frantisek Bozek

Abstract:

Trihalogenmethanes (THMs) are disinfection byproducts with non-carcinogenic and genotoxic effects. The contamination of 6 sites close to the water treatment plant has been monitored in second largest city of the Czech Republic. Health risk assessment including both non-carcinogenic and genotoxic risk for long term exposition was realized using the critical concentrations. Concentrations of trihalogenmethanes met national standards in all samples. Risk assessment proved that health risks from trihalogenmethanes are acceptable on each site.

Keywords: drinking water, health risk assessment, trihalogenmethanes, water pollution

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6435 The Effects of the Interaction between Prenatal Stress and Diet on Maternal Insulin Resistance and Inflammatory Profile

Authors: Karen L. Lindsay, Sonja Entringer, Claudia Buss, Pathik D. Wadhwa

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Maternal nutrition and stress are independently recognized as among the most important factors that influence prenatal biology, with implications for fetal development and poor pregnancy outcomes. While there is substantial evidence from non-pregnancy human and animal studies that a complex, bi-directional relationship exists between nutrition and stress, to the author’s best knowledge, their interaction in the context of pregnancy has been significantly understudied. The aim of this study is to assess the interaction between maternal psychological stress and diet quality across pregnancy and its effects on biomarkers of prenatal insulin resistance and inflammation. This is a prospective longitudinal study of N=235 women carrying a healthy, singleton pregnancy, recruited from prenatal clinics of the University of California, Irvine Medical Center. Participants completed a 4-day ambulatory assessment in early, middle and late pregnancy, which included multiple daily electronic diary entries using Ecological Momentary Assessment (EMA) technology on a dedicated study smartphone. The EMA diaries gathered moment-level data on maternal perceived stress, negative mood, positive mood and quality of social interactions. The numerical scores for these variables were averaged across each study time-point and converted to Z-scores. A single composite variable for 'STRESS' was computed as follows: (Negative mood+Perceived stress)–(Positive mood+Social interaction quality). Dietary intakes were assessed by three 24-hour dietary recalls conducted within two weeks of each 4-day assessment. Daily nutrient and food group intakes were averaged across each study time-point. The Alternative Healthy Eating Index adapted for pregnancy (AHEI-P) was computed for early, middle and late pregnancy as a validated summary measure of diet quality. At the end of each 4-day ambulatory assessment, women provided a fasting blood sample, which was assayed for levels of glucose, insulin, Interleukin (IL)-6 and Tumor Necrosis Factor (TNF)-α. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was computed. Pearson’s correlation was used to explore the relationship between maternal STRESS and AHEI-P within and between each study time-point. Linear regression was employed to test the association of the stress-diet interaction (STRESS*AHEI-P) with the biological markers HOMA-IR, IL-6 and TNF-α at each study time-point, adjusting for key covariates (pre-pregnancy body mass index, maternal education level, race/ethnicity). Maternal STRESS and AHEI-P were significantly inversely correlated in early (r=-0.164, p=0.018) and mid-pregnancy (-0.160, p=0.019), and AHEI-P from earlier gestational time-points correlated with later STRESS (early AHEI-P x mid STRESS: r=-0.168, p=0.017; mid AHEI-P x late STRESS: r=-0.142, p=0.041). In regression models, the interaction term was not associated with HOMA-IR or IL-6 at any gestational time-point. The stress-diet interaction term was significantly associated with TNF-α according to the following patterns: early AHEI-P*early STRESS vs early TNF-α (p=0.005); early AHEI-P*early STRESS vs mid TNF-α (p=0.002); early AHEI-P*mid STRESS vs mid TNF-α (p=0.005); mid AHEI-P*mid STRESS vs mid TNF-α (p=0.070); mid AHEI-P*late STRESS vs late TNF-α (p=0.011). Poor diet quality is significantly related to higher psychosocial stress levels in pregnant women across gestation, which may promote inflammation via TNF-α. Future prenatal studies should consider the combined effects of maternal stress and diet when evaluating either one of these factors on pregnancy or infant outcomes.

Keywords: diet quality, inflammation, insulin resistance, nutrition, pregnancy, stress, tumor necrosis factor-alpha

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6434 Traumatic Brain Injury Neurosurgical Care Continuum Delays in Mulago Hospital in Kampala Uganda

Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: Patients with traumatic brain injury (TBI) can develop rapid neurological deterioration from swelling and intracranial hematomas, which can result in focal tissue ischemia, brain compression, and herniation. Moreover, delays in management increase the risk of secondary brain injury from hypoxemia and hypotension. Therefore, in TBI patients with subdural hematomas (SDHs) and epidural hematomas (EDHs), surgical intervention is both necessary and time sensitive. Significant delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of TBI in Sub Saharan Africa (SSA). While many LMICs have subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold: logistical and financial barriers. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified 'three delays' framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, traumatic brain injury

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6433 Application of Random Forest Model in The Prediction of River Water Quality

Authors: Turuganti Venkateswarlu, Jagadeesh Anmala

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Excessive runoffs from various non-point source land uses, and other point sources are rapidly contaminating the water quality of streams in the Upper Green River watershed, Kentucky, USA. It is essential to maintain the stream water quality as the river basin is one of the major freshwater sources in this province. It is also important to understand the water quality parameters (WQPs) quantitatively and qualitatively along with their important features as stream water is sensitive to climatic events and land-use practices. In this paper, a model was developed for predicting one of the significant WQPs, Fecal Coliform (FC) from precipitation, temperature, urban land use factor (ULUF), agricultural land use factor (ALUF), and forest land-use factor (FLUF) using Random Forest (RF) algorithm. The RF model, a novel ensemble learning algorithm, can even find out advanced feature importance characteristics from the given model inputs for different combinations. This model’s outcomes showed a good correlation between FC and climate events and land use factors (R2 = 0.94) and precipitation and temperature are the primary influencing factors for FC.

Keywords: water quality, land use factors, random forest, fecal coliform

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6432 Dual Language Immersion Models in Theory and Practice

Authors: S. Gordon

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

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

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6431 Structural Performance of Concrete Beams Reinforced with Steel Plates: Experimental Study

Authors: Mazin Mohammed S. Sarhan

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This study presents the performance of concrete beams reinforced with steel plates as a technique of reinforcement. Three reinforced concrete beams with the dimensions of 200 mm x 300 mm x 4000 mm (width x height x length, respectively) were experimentally investigated under flexural loading. The deformed steel bars were used as the main reinforcement for the first beam. A steel plate placed horizontally was used as the main reinforcement for the second beam. The bond between the steel plate and the surrounding concrete was enhanced by using steel bolts (with a diameter of 20 mm and length of 100 mm) welded to the steel plate at a regular distance of 200 mm. A pair of steel plates placed vertically was used as the main reinforcement for the third beam. The bond between the pair steel plates and the surrounding concrete was enhanced by using 4 equal steel angles (with the dimensions of 75 mm x 75 mm and the thickness of 8 mm) for each vertical steel plate. Two steel angles were welded at each end of the steel plate. The outcomes revealed that the bending stiffness of the beams reinforced with steel plates was higher than that reinforced with deformed steel bars. Also, the flexural ductile behavior of the second beam was much higher than the rest beams.

Keywords: concrete beam, deflection, ductility, plate

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6430 3-Dimensional Contamination Conceptual Site Model: A Case Study Illustrating the Multiple Applications of Developing and Maintaining a 3D Contamination Model during an Active Remediation Project on a Former Urban Gasworks Site

Authors: Duncan Fraser

Abstract:

A 3-Dimensional (3D) conceptual site model was developed using the Leapfrog Works® platform utilising a comprehensive historical dataset for a large former Gasworks site in Fitzroy, Melbourne. The gasworks had been constructed across two fractured geological units with varying hydraulic conductivities. A Newer Volcanic (basaltic) outcrop covered approximately half of the site and was overlying a fractured Melbourne formation (Siltstone) bedrock outcropping over the remaining portion. During the investigative phase of works, a dense non-aqueous phase liquid (DNAPL) plume (coal tar) was identified within both geological units in the subsurface originating from multiple sources, including gasholders, tar wells, condensers, and leaking pipework. The first stage of model development was undertaken to determine the horizontal and vertical extents of the coal tar in the subsurface and assess the potential causality between potential sources, plume location, and site geology. Concentrations of key contaminants of interest (COIs) were also interpolated within Leapfrog to refine the distribution of contaminated soils. The model was subsequently used to develop a robust soil remediation strategy and achieve endorsement from an Environmental Auditor. A change in project scope, following the removal and validation of the three former gasholders, necessitated the additional excavation of a significant volume of residual contaminated rock to allow for the future construction of two-story underground basements. To assess financial liabilities associated with the offsite disposal or thermal treatment of material, the 3D model was updated with three years of additional analytical data from the active remediation phase of works. Chemical concentrations and the residual tar plume within the rock fractures were modelled to pre-classify the in-situ material and enhance separation strategies to prevent the unnecessary treatment of material and reduce costs.

Keywords: 3D model, contaminated land, Leapfrog, remediation

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6429 A Study on the Effect of the Mindfulness and Cultivation of Wisdom as an Intervention Strategy for College Student Internet Addiction

Authors: P. C. Li, R. H. Feng, S. J. Chen, Y. J. Yu, Y. L. Chen, X. Y. Fan

Abstract:

The purpose of this study is to investigate the effect of mindfulness and wisdom comprehensive strategy intervention on addiction to the Internet of college students by engaging fourteen intensive full-day mindfulness-based wisdom retreat curriculum. Wisdom, one of the practice method from the threefold training. Internet addiction, a kind of impulse control disorder, which attract the attentions of society due to its high prevalence and harmfulness in the last decade. Therefore, the study of internet addiction intervention is urgent. Participants with internet addiction were Chinese college students and screened by internet addiction disorder diagnose questionnaire (IAD-DQ). A quasi-experimental pretest and posttest design was used as research design. The finding shows that the mindfulness-based wisdom intervention strategy appeared to be effective in reducing the Internet addiction. Moreover, semi-structure interview method was conducted and outcomes included five themes: the reduction of internet use, the increment of awareness on emotion, self-control, present concentration and better positive lifestyle, indicating that mindfulness could be an effective intervention for this group with internet addiction.

Keywords: mindfulness, internet addiction, wisdom comprehensive intervention, cognitive-behavior therapy

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6428 A Current Problem for Steel Bridges: Fatigue Assessment of Seams´ Repair

Authors: H. Pasternak, A. Chwastek

Abstract:

The paper describes the results from a research project about repair of welds. The repair was carried out by grinding the flawed seams and re-welding them. The main task was to determine the FAT classes of original state and after repair of seams according to the assessment procedures, such as nominal, structural and effective notch stress approach. The first part shows the results of the tests, the second part encloses numerical analysis and evaluation of results to determine the fatigue strength classes according to three assessment procedures.

Keywords: cyclic loading, fatigue crack, post-weld treatment, seams’ repair

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6427 Effect of Radioprotectors on DNA Repair Enzyme and Survival of Gamma-Irradiated Cell Division Cycle Mutants of Saccharomyces pombe

Authors: Purva Nemavarkar, Badri Narain Pandey, Jitendra Kumar

Abstract:

Introduction: The objective was to understand the effect of various radioprotectors on DNA damage repair enzyme and survival in gamma-irradiated wild and cdc mutants of S. pombe (fission yeast) cultured under permissive and restrictive conditions. DNA repair process, as influenced by radioprotectors, was measured by activity of DNA polymerase in the cells. The use of single cell gel electrophoresis assay (SCGE) or Comet Assay to follow gamma-irradiation induced DNA damage and effect of radioprotectors was employed. In addition, studying the effect of caffeine at different concentrations on S-phase of cell cycle was also delineated. Materials and Methods: S. pombe cells grown at permissive temperature (250C) and/or restrictive temperature (360C) were followed by gamma-radiation. Percentage survival and activity of DNA Polymerase (yPol II) were determined after post-irradiation incubation (5 h) with radioprotectors such as Caffeine, Curcumin, Disulphiram, and Ellagic acid (the dose depending on individual D 37 values). The gamma-irradiated yeast cells (with and without the radioprotectors) were spheroplasted by enzyme glusulase and subjected to electrophoresis. Radio-resistant cells were obtained by arresting cells in S-phase using transient treatment of hydroxyurea (HU) and studying the effect of caffeine at different concentrations on S-phase of cell cycle. Results: The mutants of S. pombe showed insignificant difference in survival when grown under permissive conditions. However, growth of these cells under restrictive temperature leads to arrest in specific phases of cell cycle in different cdc mutants (cdc10: G1 arrest, cdc22: early S arrest, cdc17: late S arrest, cdc25: G2 arrest). All the cdc mutants showed decrease in survival after gamma radiation when grown at permissive and restrictive temperatures. Inclusion of the radioprotectors at respective concentrations during post irradiation incubation showed increase in survival of cells. Activity of DNA polymerase enzyme (yPol II) was increased significantly in cdc mutant cells exposed to gamma-radiation. Following SCGE, a linear relationship was observed between doses of irradiation and the tail moments of comets. The radioprotection of the fission yeast by radioprotectors can be seen by the reduced tail moments of the yeast comets. Caffeine also exhibited its radio-protective ability in radio-resistant S-phase cells obtained after HU treatment. Conclusions: The radioprotectors offered notable radioprotection in cdc mutants when added during irradiation. The present study showed activation of DNA damage repair enzyme (yPol II) and an increase in survival after treatment of radioprotectors in gamma irradiated wild type and cdc mutants of S. pombe cells. Results presented here showed feasibility of applying SCGE in fission yeast to follow DNA damage and radioprotection at high doses, which are not feasible with other eukaryotes. Inclusion of caffeine at 1mM concentration to S phase cells offered protection and did not decrease the cell viability. It can be proved that at minimal concentration, caffeine offered marked radioprotection.

Keywords: radiation protection, cell cycle, fission yeast, comet assay, s-phase, DNA repair, radioprotectors, caffeine, curcumin, SCGE

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6426 Chemically Enhanced Primary Treatment: Full Scale Trial Results Conducted at a South African Wastewater Works

Authors: Priyanka Govender, S. Mtshali, Theresa Moonsamy, Zanele Mkwanazi, L. Mthembu

Abstract:

Chemically enhanced primary treatment (CEPT) can be used at wastewater works to improve the quality of the final effluent discharge, provided that the plant has spare anaerobic digestion capacity. CEPT can transfer part of the organic load to the digesters thereby effectively relieving the hydraulic loading on the plant and in this way can allow the plant to continue operating long after the hydraulic capacity of the plant has been exceeded. This can allow a plant to continue operating well beyond its original design capacity, requiring only fairly simple and inexpensive modifications to the primary settling tanks as well as additional chemical costs, thereby delaying or even avoiding the need for expensive capital upgrades. CEPT can also be effective at plants where high organic loadings prevent the wastewater discharge from meeting discharge standards, especially in the case of COD, phosphates and suspended solids. By increasing removals of these pollutants in the primary settling tanks, CEPT can enable the plant to conform to specifications without the need for costly upgrades. Laboratory trials were carried out recently at the Umbilo WWTW in Durban and these were followed by a baseline assessment of the current plant performance and a subsequent full scale trial on the Conventional plant i.e. West Plant. The operating conditions of the plant are described and the improvements obtained in COD, phosphate and suspended solids, are discussed. The PST and plant overall suspended solids removal efficiency increased by approximately 6% during the trial. Details regarding the effect that CEPT had on sludge production and the digesters are also provided. The cost implications of CEPT are discussed in terms of capital costs as well as operation and maintenance costs and the impact of Ferric chloride on the infrastructure was also studied and found to be minimal. It was concluded that CEPT improves the final quality of the discharge effluent, thereby improving the compliance of this effluent with the discharge license. It could also allow for a delay in upgrades to the plant, allowing the plant to operate above its design capacity. This will be elaborated further upon presentation.

Keywords: chemically enhanced, ferric, wastewater, primary

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6425 Incidence of Lymphoma and Gonorrhea Infection: A Retrospective Study

Authors: Diya Kohli, Amalia Ardeljan, Lexi Frankel, Jose Garcia, Lokesh Manjani, Omar Rashid

Abstract:

Gonorrhea is the second most common sexually transmitted disease (STDs) in the United States of America. Gonorrhea affects the urethra, rectum, or throat and the cervix in females. Lymphoma is a cancer of the immune network called the lymphatic system that includes the lymph nodes/glands, spleen, thymus gland, and bone marrow. Lymphoma can affect many organs in the body. When a lymphocyte develops a genetic mutation, it signals other cells into rapid proliferation that causes many mutated lymphocytes. Multiple studies have explored the incidence of cancer in people infected with STDs such as Gonorrhea. For instance, the studies conducted by Wang Y-C and Co., as well as Caini, S and Co. established a direct co-relationship between Gonorrhea infection and incidence of prostate cancer. We hypothesize that Gonorrhea infection also increases the incidence of Lymphoma in patients. This research study aimed to evaluate the correlation between Gonorrhea infection and the incidence of Lymphoma. The data for the research was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database. This database was utilized to evaluate patients infected with Gonorrhea versus the ones who were not infected to establish a correlation with the prevalence of Lymphoma using ICD-10 and ICD-9 codes. Access to the database was granted by the Holy Cross Health, Fort Lauderdale for academic research. Standard statistical methods were applied throughout. Between January 2010 and December 2019, the query was analyzed and resulted in 254 and 808 patients in both the infected and control group, respectively. The two groups were matched by Age Range and CCI score. The incidence of Lymphoma was 0.998% (254 patients out of 25455) in the Gonorrhea group (patients infected with Gonorrhea that was Lymphoma Positive) compared to 3.174% and 808 patients in the control group (Patients negative for Gonorrhea but with Lymphoma). This was statistically significant by a p-value < 2.210-16 with an OR= 0.431 (95% CI 0.381-0.487). The patients were then matched by antibiotic treatment to avoid treatment bias. The incidence of Lymphoma was 1.215% (82 patients out of 6,748) in the Gonorrhea group compared to 2.949% (199 patients out of 6748) in the control group. This was statistically significant by a p-value <5.410-10 with an OR= 0.468 (95% CI 0.367-0.596). The study shows a statistically significant correlation between Gonorrhea and a reduced incidence of Lymphoma. Further evaluation is recommended to assess the potential of Gonorrhea in reducing Lymphoma.

Keywords: gonorrhea, lymphoma, STDs, cancer, ICD

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6424 Baby Cot’s Indoor Air Quality

Authors: Wim Zeiler

Abstract:

The indoor quality of occupied space is very important for the well-being of its occupants, especially in the case of babies. The lungs of a young child are still growing and adverse conditions could affect this development. Presently little children spend a lot of their time in day care centers while parents are at work. Little is known about the effects of different indoor environmental factors present in these day care centers and the quality of air of baby cots in which the babies are accommodated in these day care centers. Therefore this research investigated the quality of the accommodation of Dutch day care centers. Besides an extensive literature research actual measurements were performed in baby cots within three-day care center. Some experiments were performed to find out the importance of the configuration and types of baby cots. This research investigated the quality of the accommodation of a Dutch day care center which led to a tool describing the quality needs (e.g., quality standard) for the accommodation of day care centers. The results of our detailed studies were compared with the results of earlier Dutch more global studies in day care centers, in which more than 60 day care centers were investigated. Also the results are compared with the outcomes of research on school ventilation. The results proved that the situation in day care centers is even worse than that of schools within the Netherlands. More attention is needed to improve the current situation.

Keywords: ventilation, baby cots, day care centers, case study

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6423 Developing Customizable Scaffolds With Antimicrobial Properties for Vascular Tissue Regeneration Using Low Temperature Plasma

Authors: Komal Vig, Syamala Soumyakrishnan, Yadav Baral

Abstract:

Bypass surgery, using the autologous vein has been one of the most effective treatments for cardiovascular diseases (CVD). More recently tissue engineering including engineered vascular grafts to synthesize blood vessels is gaining usage. Dacron and ePTFE has been employed for vascular grafts, however, these does not work well for small diameter grafts (<6 mm) due to intimal hyperplasia and thrombosis. In the present study PTFE was treated with LTP to improve the endothelialization of intimal surface of graft. Scaffolds were also modified with polyvinylpyrrolidone coated silver nanoparticles (Ag-PVP) and the antimicrobial peptides, p753 and p359. Human umbilical vein endothelial cells (HUVEC) were plated on the developed scaffolds and cell proliferation was determined by the MTT assay. Cells attachment on scaffolds was visualized by microscopy. mRNA expressions levels of different cell markers were investigated using quantitative real-time PCR (qPCR). X ray photoelectron spectroscopic confirmed the introduction of oxygenated functionalities from LTP air plasma. Microscopic and MTT assays indicated increase in cell viability in LTP treated scaffolds. Gene expression studies shows enhanced expression of cell adhesion marker Integrin- α 5 gene after LTP treatment. The KB test displayed a zone of inhibition for Ag-PVP, p753 and p359 of 19mm, 14mm, and 12mm respectively. To determine toxicity of antimicrobial agents to cells, MTT Assay was performed using HEK293 cells. MTT Assay exhibited that Ag-PVP and the peptides were non-toxic to cells at 100μg/mL and 50μg/mL, respectively. Live/dead analysis and plate count of treated bacteria exhibited bacterial inhibition on develop scaffold compared to non-treated scaffold. SEM was performed to analyze the structural changes of bacteria after treatment with antimicrobial agents. Gene expression studies were conducted on RNA from bacteria treated with Ag-PVP and peptides using qRT-PCR. Based on our initial results, more scaffolds alternatives will be developed and investigated for cell growth and vascularization studies.

Keywords: low temperature plasma, vascular graft, HUVEC cells, antimicrobial

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6422 An Investigation on the Relationship between Taxi Company Safety Climate and Safety Performance of Taxi Drivers in Iloilo City

Authors: Jasper C. Dioco

Abstract:

The study was done to investigate the relationship of taxi company safety climate and drivers’ safety motivation and knowledge on taxi drivers’ safety performance. Data were collected from three Taxi Companies with taxi drivers as participants (N = 84). The Hiligaynon translated version of Transportation Companies’ Climate Scale (TCCS), Safety Motivation and Knowledge Scale, Occupational Safety Motivation Questionnaire and Global Safety Climate Scale were used to study the relationships among four parameters: (a) Taxi company safety climate; (b) Safety motivation; (c) Safety knowledge; and (d) Safety performance. Correlational analyses found that there is no relation between safety climate and safety performance. A Hierarchical regression demonstrated that safety motivation predicts the most variance in safety performance. The results will greatly impact how taxi company can increase safe performance through the confirmation of the proximity of variables to organizational outcome. A strong positive safety climate, in which employees perceive safety to be a priority and that managers are committed to their safety, is likely to increase motivation to be safety. Hence, to improve outcomes, providing knowledge based training and health promotion programs within the organization must be implemented. Policy change might include overtime rules and fatigue driving awareness programs.

Keywords: safety climate, safety knowledge, safety motivation, safety performance, taxi drivers

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6421 Construction Contractor Pre-Qualification Using Multi-Attribute Utility Theory: A Multiplicative Approach

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

Abstract:

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

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

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6420 Mathematical Games with RPG and Sci-Fi Elements to Enhance Motivation

Authors: Santiago Moll Lopez, Erica Vega Fleitas, Dolors Rosello Ferragud, Luis Manuel Sanchez Ruiz, Jose Antonio Moraño Fernandez

Abstract:

Game-based learning (GBL) is becoming popular in education. Learning through games offers students a motivating experience related to the social aspect of games. Among the significant positive outcomes are promoting positive emotions and collaboration, improving the assimilation of concepts, and creating an attractive and dynamic environment standout. This work presents a study of the design and implementation of games created with RPG Maker MZ software with a Sci-Fi storytelling environment for developing specific and transversal skills in a Mathematics subject at the Beng in Aerospace Engineering. Games were applied during regular classes and as a part of a Flip-Teaching methodology to increase the motivation and the assimilation of mathematical concepts in an engaging way. The key features of the games were the introduction of avatar design and the promotion of collaboration among students. Students' opinions and grades obtained in the activities and exams showed increased motivation and a significant improvement in their performance compared with other groups or past students' performances.

Keywords: game-based learning, rol games, mathematics, science fiction

Procedia PDF Downloads 99
6419 Public Health Campaign to Eradicate Hepatitis C Virus during the Covid-19 Emergency in the North-East of Italy

Authors: Emanuela Zilli, Antonio Madia, Milvia Marchiori, Paola Anello, Chiara Cabbia, Emanuela Velo, Delia Campagnolo, Michele Scomazzon, Emanuela Salvatico, S. Tikvina, Antonio Miotti

Abstract:

Hepatitis C is an inflammation of the liver caused by the hepatitis C virus (HCV). Antiviral medicines can cure more than 95% of cases of hepatitis C infection, but access to diagnosis and treatment remains low. The ULSS 6 Euganea – Health Trust has implemented a campaign to eradicate hepatitis C in the province of Padua (North-East of Italy), which can be subdivided into three areas: North (300.000 inhabitants), Centre (400.000) and South (300.000). In September 2021, the project was launched in the Northern area; a set of brochures was distributed in outpatient services, general practitioners’ clinics and offices, community pharmacy services, social health districts, and through social networks. The Hepatology Service contacted 460 patients selected by the Clinical Laboratory (positivity for HCV antibodies): 83 patients (18.0%) had been already cured of HCV infection, missing or deceased; 377 patients (82.0%) met the criteria to be eligible for HCV eradication therapy and were therefore included in a Day Service specific agenda and followed by a multidisciplinary team of healthcare professionals, with a dedicated telephone line. Haemato-chemical tests, general medical check-ups and ultrasound tests with fibroscan were performed. Patients were tested for Sars-CoV-2 positivity; those not yet vaccinated against Covid-19 were encouraged to complete the vaccination scheme. All 377 patients (100%) received HCV eradication therapy at the community pharmacy service; a detailed explanation of how to take their medication was provided. At the end of the first phase, Covid-19 vaccination rate was 100% (377/377), including patients already vaccinated and new-vaccinated. Check-up appointments were arranged after 2 or 3 months, according to the treatment plan. The awareness campaign and the organization of HCV eradication therapy service by ULSS 6 Euganea are proving to be effective; the project is now going to be applied to Central and Southern areas of the province (1.132 patients).

Keywords: public health, HCV-eradication, Covid-19 emergency, health communication strategies

Procedia PDF Downloads 111
6418 Imaging Spectrum of Central Nervous System Tuberculosis on Magnetic Resonance Imaging: Correlation with Clinical and Microbiological Results

Authors: Vasundhara Arora, Anupam Jhobta, Suresh Thakur, Sanjiv Sharma

Abstract:

Aims and Objectives: Intracranial tuberculosis (TB) is one of the most devastating manifestations of TB and a challenging public health issue of considerable importance and magnitude world over. This study elaborates on the imaging spectrum of neurotuberculosis on magnetic resonance imaging (MRI) in 29 clinically suspected cases from a tertiary care hospital. Materials and Methods: The prospective hospital based evaluation of MR imaging features of neuro-tuberculosis in 29 clinically suspected cases was carried out in Department of Radio-diagnosis, Indira Gandhi Medical Hospital from July 2017 to August 2018. MR Images were obtained on a 1.5 T Magnetom Avanto machine and were analyzed to identify any abnormal meningeal enhancement or parenchymal lesions. Microbiological and Biochemical CSF analysis was performed in radio-logically suspected cases and the results were compared with the imaging data. Clinical follow up of the patients started on anti-tuberculous treatment was done to evaluate the response to treatment and clinical outcome. Results: Age range of patients in the study was between 1 year to 73 years. The mean age of presentation was 11.5 years. No significant difference in the distribution of cerebral tuberculosis was noted among the two genders. Imaging findings of neuro-tuberculosis obtained were varied and non specific ranging from lepto-meningeal enhancement, cerebritis to space occupying lesions such as tuberculomas and tubercular abscesses. Complications presenting as hydrocephalus (n= 7) and infarcts (n=9) was noted in few of these patients. 29 patients showed radiological suspicion of CNS tuberculosis with meningitis alone observed in 11 cases, tuberculomas alone were observed in 4 cases, meningitis with parenchymal tuberculomas in 11 cases. Tubercular abscess and cerebritis were observed in one case each. Tuberculous arachnoiditis was noted in one patient. Gene expert positivity was obtained in 11 out of 29 radiologically suspected patients; none of the patients showed culture positivity. Meningeal form of the disease alone showed higher positivity rate of gene Xpert (n=5) followed by combination of meningeal and parenchymal forms of disease (n=4). The parenchymal manifestation of disease alone showed least positivity rates (n= 3) with gene xpert testing. All 29 patients were started on anti tubercular treatment based on radiological suspicion of the disease with clinical improvement observed in 27 treated patients. Conclusions: In our study, higher incidence of neuro- tuberculosis was noted in paediatric population with predominance of the meningeal form of the disease. Gene Xpert positivity obtained was low due to paucibacillary nature of cerebrospinal fluid (CSF) with even lower positivity of CSF samples in parenchymal form of the manifestation. MRI showed high accuracy in detecting CNS lesions in neuro-tuberculosis. Hence, it can be concluded that MRI plays a crucial role in the diagnosis because of its inherent sensitivity and specificity and is an indispensible imaging modality. It caters to the need of early diagnosis owing to poor sensitivity of microbiological tests more so in the parenchymal manifestation of the disease.

Keywords: neurotuberculosis, tubercular abscess, tuberculoma, tuberculous meningitis

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